Acute Kidney Injury More Likely in African Americans
Increased risk observed in the VA health system unlikely to be fully explained by disparities in access to care.
SAN DIEGO—Acute kidney injury (AKI) is more likely to develop in African-Americans than Caucasians hospitalized in the Veterans Administration (VA) health system, but this increased risk is unlikely to be fully explained by disparities in access to care, researchers reported at Kidney Week.
In a retrospective study of 180,429 VA hospitalizations Michael Heung, MD, of the University of Michigan in Ann Arbor, and collaborators found that AKI occurred in 23.2% of African-American (AA) patient admissions versus 18.5% of Caucasian patient admissions. AA race was independently associated with a 26% increased risk of AKI compared with Caucasian race, after adjusting for age, sex, baseline estimated glomerular filtration rate (eGFR), geographic region, severity of illness during hospitalization, and co-morbidities, including diabetes, hypetension, coronary heart disease (CHD), and congestive heart failure.
The researchers defined AKI as a 0.3 mg/dL or greater increase in serum creatinine from pre-admission baseline.
Compared with Caucasians, AA patients had a significantly higher prevalence of diabetes (43.1% vs. 41.1%), lower prevalence of CHD (45.7% vs. 58.8%), lower Charlson co-morbidity scores (1.4 vs. 1.6), and higher baseline eGFR (89.2 vs. 81.7 mL/min/1.73 m2).
“Given that VA patients have similar healthcare access and benefits, our results suggest that the increased AKI risk seen in AA [patients] is unlikely to be fully accounted for by disparities in access to care,” the authors concluded.