Dialysis-Requiring AKI Rises Sharply
PHILADELPHIA—Acute kidney injury (AKI), also known as acute renal failure, requiring dialysis has become more common than end-stage renal disease (ESRD) requiring renal replacement therapy (RRT), according to findings presented at Kidney Week 2011.
From 1998 to 2008, the U.S. incidence rate of dialysis-requiring AKI increased from 201 to 496 cases per million person-years, an average annual increase of 10%, reported a team at the University of California, San Francisco, led by Raymond K. Hsu, MD. The population incidence rate of dialysis-requiring AKI exceeded that of RRT-requiring ESRD since 2005. In 2008, the population incidence rate of dialysis-requiring AKI was 496 cases per million person-years compared with 351 cases per million person-years for RRT-requiring ESRD (defined as requiring chronic dialysis or kidney transplantation).
When the investigators controlled for temporal changes in population distribution of race, age, gender and trends of sepsis, acute heart failure, and use of cardiac catheterization and mechanical ventilation, the incidence rate decreased on slightly to 8% per year.
Dialysis-requiring AKI was 8.1 times more common among patients older than 65 than younger patients, 1.7 times more common among blacks than whites, and 1.3 times more common among men than women.
“Our study shows that the incidence of dialysis-requiring AKI has more than doubled in the last decade and underscores the true public health burden of AKI to the medical and lay community,” the study's senior author, Chi-yuan Hsu, MD, told Renal & Urology News. “Defining the true population of AKI on a population level is important to inform the appropriate allocation of healthcare resources to target disease prevention and treatment appropriately.”