Chronic kidney disease (CKD) increases the risk for acute kidney injury (AKI) requiring dialysis in patients hospitalized with pneumonia, investigators reported at the National Kidney Foundation’s 2023 Spring Clinical Meetings in Austin, Texas.

The finding is based on an analysis of 1,459,854 hospitalizations with a primary diagnosis of pneumonia identified using 2019 data from the National Inpatient Sample, the largest publicly available all-payer inpatient care database in the United States. Sae X. Morita, MD, of SBH Health System in New York, New York, and colleagues found that AKI requiring dialysis occurred significantly more frequently among patients with vs without CKD (2.5% vs 0.03%). The mortality rate also was significantly higher among patients with CKD (6.4% vs 4.4%).

In a multivariable analysis comparing 7425 patients with CKD and 3140 without CKD, the researchers found that women in the CKD and non-CKD cohorts had significant 14% and 36% decreased odds of AKI requiring dialysis, respectively, compared with men. Further, compared with White patients, Black, Hispanic, and Asian patients in the CKD population had significant 37%, 97%, and 68% increased odds of AKI requiring dialysis. The odds of AKI requiring dialysis did not differ significantly by race or ethnicity among patients without CKD.

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Admission to urban, teaching, privately owned hospitals (rather than rural or nonteaching hospitals) was associated with significantly higher odds of AKI requiring dialysis regardless of CKD status.


Morita SX, Deda X, Melamed M. Risk factors for acute kidney injury (AKI) requiring dialysis in patients with and without chronic kidney disease (CKD), during an admission for pneumonia using a nationally representative sample. Presented at: NKF 2023, Austin, Texas, April 11-15. Poster 19.