TY - JOUR
T1 - Dialysis-Requiring Acute Kidney Injury in Denmark 2000-2012
T2 - Time Trends of Incidence and Prevalence of Risk Factors - A Nationwide Study
AU - Carlson, Nicholas
AU - Hommel, Kristine
AU - Olesen, Jonas Bjerring
AU - Soja, Anne Merete Boas
AU - Lauritsen, Tina Vilsbøll
AU - Kamper, Anne-Lise
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
PY - 2016/2
Y1 - 2016/2
N2 - 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.
AB - 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.
KW - Acute Kidney Injury
KW - Aged
KW - Aged, 80 and over
KW - Cardiovascular Diseases
KW - Cohort Studies
KW - Comorbidity
KW - Denmark
KW - Diabetes Mellitus
KW - Drug Utilization
KW - Female
KW - Humans
KW - Incidence
KW - Liver Diseases
KW - Male
KW - Middle Aged
KW - Morbidity
KW - Neoplasms
KW - Prevalence
KW - Pulmonary Disease, Chronic Obstructive
KW - Registries
KW - Renal Dialysis
KW - Retrospective Studies
KW - Risk Factors
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1371/journal.pone.0148809
DO - 10.1371/journal.pone.0148809
M3 - Journal article
C2 - 26863015
SN - 1932-6203
VL - 11
SP - 1
EP - 14
JO - PLoS Computational Biology
JF - PLoS Computational Biology
IS - 2
M1 - e0148809
ER -
