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. 2016 Feb 10;11(2):e0148809.
doi: 10.1371/journal.pone.0148809. eCollection 2016.

Dialysis-Requiring Acute Kidney Injury in Denmark 2000-2012: Time Trends of Incidence and Prevalence of Risk Factors-A Nationwide Study

Nicholas Carlson  1   2 , Kristine Hommel  2 , Jonas Bjerring Olesen  1 , Anne-Merete Soja  3 , Tina Vilsbøll  4 , Anne-Lise Kamper  5 , Christian Torp-Pedersen  6 , Gunnar Gislason  1
Affiliations

Dialysis-Requiring Acute Kidney Injury in Denmark 2000-2012: Time Trends of Incidence and Prevalence of Risk Factors-A Nationwide Study

Nicholas Carlson et al. PLoS One. .

Abstract

Introduction: Dialysis-requiring acute kidney injury is a severe illness associated with poor prognosis. However, information pertaining to incidence rates and prevalence of risk factors remains limited in spite of increasing focus. We evaluate time trends of incidence rates and changing patterns in prevalence of comorbidities, concurrent medication, and other risk factors in nationwide retrospective cohort study.

Materials and methods: All patients with dialysis-requiring acute kidney injury were identified between January 1st 2000 and December 31st 2012. By cross-referencing data from national administrative registries, the association of changing patterns in dialysis treatment, comorbidity, concurrent medication and demographics with incidence of dialysis-requiring acute kidney injury was evaluated.

Results: A total of 18,561 adult patients with dialysis-requiring AKI were identified between 2000 and 2012. Crude incidence rate of dialysis-requiring AKI increased from 143 per million (95% confidence interval, 137-144) in 2000 to 366 per million (357-375) in 2006, and remained stable hereafter. Notably, incidence of continuous veno-venous hemodialysis (CRRT) and use of acute renal replacement therapy in elderly >75 years increased substantially from 23 per million (20-26) and 328 per million (300-355) in 2000, to 213 per million (206-220) and 1124 per million (1076-1172) in 2012, respectively. Simultaneously, patient characteristics and demographics shifted towards increased age and comorbidity.

Conclusions: Although growth in crude incidence rate of dialysis-requiring AKI stabilized in 2006, continuous growth in use of CRRT, and acute renal replacement therapy of elderly patients >75 years, was observed. Our results indicate an underlying shift in clinical paradigm, as opposed to unadulterated growth in incidence of dialysis-requiring AKI.

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Conflict of interest statement

Competing Interests: JO: Has received speaker fees and funding for research from Bristol-Myers Squibb and Boehringer Ingelheim, the Lundbeck Foundation, and The Capital Region of Denmark. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flow chart depicting study design and exclusion criteria.
Fig 2
Fig 2. Crude incidence rate per million and frequency of dialysis-requiring acute kidney injury in Denmark between 2000 and 2012.
Incidence rate shown as boxplot with 95% CI and regression, and frequency shown as a histogram.
Fig 3
Fig 3. Modality-specific incidence per million of dialysis-requiring acute kidney injury in Denmark between 2000 and 2012.
Boxplot with 95% CI and regressions.
Fig 4
Fig 4. Age-stratified incidence per million of dialysis-requiring acute kidney injury in Denmark between 2000 and 2012.
Boxplot with 95% CI and regressions.
Fig 5
Fig 5. Incidence of surgical and non-surgical dialysis-requiring acute kidney injury per million in Denmark between 2000 and 2012.
Incidence rate shown as boxplot with 95% CI and regressions, and frequency shown as a histogram.
See this image and copyright information in PMC

References

    1. Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, et al. (2013) Acute kidney injury: an increasing global concern. Lancet 382: 170–179. 10.1016/S0140-6736(13)60647-9 - DOI - PubMed
    1. Matuszkiewicz-Rowinska J, Zebrowski P, Koscielska M, Malyszko J, Mazur A (2015) The growth of acute kidney injury: Eastern European perspective. Kidney Int 87: 1264 10.1038/ki.2015.61 - DOI - PubMed
    1. Siew ED, Davenport A (2015) The growth of acute kidney injury: a rising tide or just closer attention to detail? Kidney Int 87: 46–61. 10.1038/ki.2014.293 - DOI - PMC - PubMed
    1. Wonnacott A, Meran S, Amphlett B, Talabani B, Phillips A (2014) Epidemiology and Outcomes in Community-Acquired Versus Hospital-Acquired AKI. Clin J Am Soc Nephrol. - PMC - PubMed
    1. Thakar CV, Christianson A, Almenoff P, Freyberg R, Render ML (2013) Degree of Acute Kidney Injury before Dialysis Initiation and Hospital Mortality in Critically Ill Patients. Int J Nephrol 2013: 827459 10.1155/2013/827459 - DOI - PMC - PubMed

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