AKI may be linked to higher dialysis need, mortality for hospitalized patients
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Key takeaways:
- The study compared social determinants of health between Kuwaiti patients and those who were not Kuwaiti.
- Patients who were not Kuwaiti had more community-acquired AKI and AKI that occurred during the summer.
AKI may be liker with a higher need for dialysis and higher mortality for hospitalized patients in a study that compared social determinants of health between patient groups.
“AKI, which is characterized by an abrupt increase in serum creatinine levels, leads to significant morbidity and mortality,” Ali AlSahow, MB, ChB, head of nephrology at Jahra Hospital in Al Jahra, Kuwait, and colleagues wrote in the prospective study conducted in Kuwait. “Poor access to health care increases the risk for kidney disease, and low socioeconomic status is associated with higher AKI incidence, more severe AKI and higher mortality.”
Researchers delved into how health care access and socioeconomic status impacted AKI status across seven public hospitals in Kuwait in 2021.
“Most expatriates have a lower income than Kuwaitis, cannot afford private health care because of its prohibitive cost, and are forced into substandard housing conditions and consumption of cheap unhealthy food,” the researchers wrote. “The majority are also working more physically demanding jobs at longer hours.”
The observational cohort study included 3,744 patients, representing 3.2% of hospitalizations and 19.5% of ICU admissions.
Patients with AKI included in the study had a mean age of 63 years and mean eGFR of 66.7 mL/min. Patients who were ethnically diverse non-Kuwaiti (expatriates) represented 42.3% of the sample.
Researchers used Kidney Disease: Improving Global Outcomes serum creatinine-based criteria to identify AKI. Main objectives were 30-day mortality, need for dialysis, kidney recovery rates and differences in outcomes between patients who were Kuwaiti and individuals who were not Kuwaiti.
Overall, 33.5% of patients had dialysis, with a greater need among patients who were not Kuwaiti (35.5% vs. 32.1%), results showed. At 30 days, 34.4% of patients died, accounting for 24.8% of hospital mortality and 59.8% of ICU mortality, according to the researchers.
Patients who were not Kuwaiti tended to be younger (57.6 vs. 66.9 years), had higher baseline eGFR (73.1 mL/min vs. 62 mL/min), more community-acquired AKI (53.8% vs. 46.7%) and AKI during the summer (34.7% vs. 26.9%), according to the researchers.
Patients who were not Kuwaiti had similar mortality and complete kidney recovery rates.
“Although more Kuwaitis were affected by AKI, the mortality rates for Kuwaitis and non-Kuwaitis were similar,” the researchers wrote. “Non-Kuwaitis were younger with better baseline kidney function and fewer chronic diseases than Kuwaitis.”
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