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Review
. 2019 Jun 27;8(7):927.
doi: 10.3390/jcm8070927.

Incidence and Cost of Acute Kidney Injury in Hospitalized Patients with Infective Endocarditis

Victor Ortiz-Soriano  1 , Katherine Donaldson  2 , Gaixin Du  3 , Ye Li  4 , Joshua Lambert  5 , Dan Cleland  6 , Alice Thornton  7 , Laura C Fanucchi  8 , Moises A Huaman  9   10 , Javier A Neyra  11
Affiliations
Review

Incidence and Cost of Acute Kidney Injury in Hospitalized Patients with Infective Endocarditis

Victor Ortiz-Soriano et al. J Clin Med. .

Abstract

Acute kidney injury (AKI) is a frequent complication of hospitalized patients with infective endocarditis (IE). Further, AKI in the setting of IE is associated with high morbidity and mortality. We aimed to examine the incidence, clinical parameters, and hospital costs associated with AKI in hospitalized patients with IE in an endemic area with an increasing prevalence of opioid use. This retrospective cohort study included 269 patients admitted to a major referral center in Kentucky with a primary diagnosis of IE from January 2013 to December 2015. Of these, 178 (66.2%) patients had AKI by Kidney Disease Improving Global Outcomes (KDIGO) serum creatinine criteria: 74 (41.6%) had AKI stage 1 and 104 (58.4%) had AKI stage ≥2. In multivariable analysis, higher comorbidity scores and the need for diuretics were independently associated with AKI, while the involvement of the tricuspid valve and the need for vasopressor/inotrope support were independently associated with severe AKI (stage ≥2). The median total direct cost of hospitalization was progressively higher according to each stage of AKI ($17,069 for no AKI; $37,111 for AKI stage 1; and $61,357 for AKI stage ≥2; p < 0.001). In conclusion, two-thirds of patients admitted to the hospital due to IE had incident AKI. The occurrence of AKI significantly increased healthcare costs. The higher level of comorbidity, the affection of the tricuspid valve, and the need for diuretics and/or vasoactive drugs were associated with severe AKI in this susceptible population.

Keywords: acute kidney injury; healthcare costs; infective endocarditis; opioid use.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Cohort derivation. Abbreviations: AKI (acute kidney injury), eGFR (estimated glomerular filtration rate), ESRD (end-stage renal disease), IE (infective endocarditis).
Figure 2
Figure 2
Incidence of acute kidney injury and median total hospitalization direct cost in hospitalized patients with a primary diagnosis of infective endocarditis.
See this image and copyright information in PMC

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