MANAGED CARE January 2013. ©MediMedia USA
News & Commentary
Acute Kidney Injuries Double Over 10 Years
Acute kidney injuries (AKIs) increased greatly from 2000 to 2009 in terms of both incidence and mortality rates, according to a study in the Journal of the American Society of Nephrology.
The authors describe acute kidney injuries as those requiring dialysis.
“The total number of deaths associated with dialysis-requiring AKI rose from 18,000 in 2000 to nearly 39,000 in 2009,” says the study “Temporal Changes in Incidence of Dialysis-Requiring AKI.” The authors continue that “the incidence of dialysis-requiring AKI increased rapidly in all patient subgroups in the past decade in the United States, and the number of deaths associated with dialysis-requiring AKI more than doubled.”
AKIs requiring dialysis rose about 10 percent annually. The number of hospitalizations resulting from the condition increased from 63,000 to 164,000. “In subgroup analyses, we found that dialysis-requiring AKI was more common in the elderly (versus younger age groups), men (versus women), and non-Hispanic blacks (versus non-Hispanic whites),” says the study. “All age, sex, and racial–ethnic subgroups showed a similar pattern of increase in disease incidence over the study period.”
When experts cite the epidemic of kidney disease, they are usually referring to chronic kidney disease (CKD) and/or endstage renal disease (ESRD), and “policy discussions related to kidney disease have mostly addressed ESRD and CKD,” the authors note.
“Because the number of non-dialysis-requiring AKI cases is approximately 10 [times as high as] the number of dialysis-requiring AKI cases and because even small acute changes in serum creatinine are associated with increased morbidity and mortality, our data likely represent only the tip of the iceberg in terms of the public health burden of AKI.”