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. 2019 Jun 7;9(1):65.
doi: 10.1186/s13613-019-0534-7.

Changes in acute kidney injury epidemiology in critically ill patients: a population-based cohort study in Korea

Subin Hwang  1 , Hyejeong Park  2 , Youngha Kim  2 , Danbee Kang  2   3 , Ho Suk Ku  1 , Juhee Cho  2   3 , Jung Eun Lee  4 , Wooseong Huh  4 , Eliseo Guallar  2   5 , Gee Young Suh  6   7 , Hye Ryoun Jang  8
Affiliations

Changes in acute kidney injury epidemiology in critically ill patients: a population-based cohort study in Korea

Subin Hwang et al. Ann Intensive Care. .

Abstract

Background: Although no specific treatment facilitates renal tubular regeneration in acute kidney injury (AKI), the rapid increase in aging populations with more comorbidities and advances in critical care management are expected to change the epidemiology of AKI. However, few recent studies dissected the current epidemiologic characteristics of critically ill patients with AKI. We investigated recent epidemiologic changes in severe AKI in critically ill patients.

Methods: All adult admissions to intensive care units (ICUs) in Korea from 2008 to 2015 were screened using the national health insurance review and assessment database, and 1,744,235 patients were included. Clinical characteristics and changes in AKI incidence and mortality rate were analyzed.

Results: The incidence of AKI increased from 7.4% in 2008 to 8.3% in 2015 (p for trend < 0.001). Age-standardized AKI rate was 7018.6 per 100,000 person-years. In-hospital mortality significantly decreased from 39.1% in 2008 to 37.2% in 2015 (p for trend < 0.001) with 2427.6 deaths per 100,000 person-years. Patients with AKI showed higher in-hospital mortality, prolonged ICU length of stay, and higher total cost. Multivariable analysis showed increased risk of in-hospital mortality (adjusted odds ratio [OR] 3.74), mechanical ventilation (OR 2.87), ECMO (OR 6.99), and vasopressor requirement (OR 2.75) in patients with AKI.

Conclusions: Recent advances in medical management for AKI have improved in-hospital mortality of critically ill patients with AKI despite increases in the elderly population and AKI incidence.

Keywords: Acute kidney injury; Critically ill patients; Intensive care unit; Mortality.

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Conflict of interest statement

The authors declare that they have no competing interests. The results presented in this article have not been published previously in whole or part, except in abstract format.

Figures

Fig. 1
Fig. 1
Yearly trends of acute kidney injury in critically ill patients in Korea between 2008 and 2015. Bars represent absolute number of critically ill patients with acute kidney injury (AKI); lines represent proportion of critically ill patients with AKI among all ICU patients. Incidence increased from 7.4% in 2008 to 8.3% in 2015 (p for trend < 0.001)
Fig. 2
Fig. 2
In-hospital mortality rate in critically ill patients with acute kidney injury in Korea between 2008 and 2015. Bars represent absolute number of deaths in critically ill patients with acute kidney injury (AKI); lines represent mortality of critically ill patients with AKI. Mortality decreased from 39.1 to 37.2% (p for trend < 0.001)
See this image and copyright information in PMC

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