Racial and Ethnic Disparities in Pregnancy-Related Acute Kidney Injury
Copyright © 2020 by the American Society of Nephrology..
Background: Pregnancy-related AKI (PR-AKI) is increasing in the United States. PR-AKI is associated with adverse maternal outcomes. Disparities in racial/ethnic differences in PR-AKI by race have not been studied.
Methods: This was a retrospective cohort study using the National Inpatient Sample (NIS) from 2005 to 2015. We identified patients who were admitted for a pregnancy-related diagnosis using the Neomat variable provided by the NIS database that indicates the presence of a maternal or neonatal diagnosis code or procedure code. PR-AKI was identified using ICD codes. Survey logistic regression was used for multivariable analysis adjusting for age, medical comorbidities, socioeconomic factors, and hospital/admission factors.
Results: From 48,316,430 maternal hospitalizations, 34,001 (0.07%) were complicated by PR-AKI. Hospitalizations for PR-AKI increased from 3.5/10,000 hospitalizations in 2005 to 11.8/10,000 hospitalizations in 2015 with the largest increase seen in patients aged ≥35 and black patients. PR-AKI was associated with higher odds of miscarriage (adjusted odds ratio [aOR], 1.64; 95% CI, 1.34 to 2.07) and mortality (aOR, 1.53; 95% CI, 1.25 to 1.88). After adjustment for age, medical comorbidities, and socioeconomic factors, blacks were more likely than whites to develop PR-AKI (aOR, 1.17; 95% CI, 1.04 to 1.33). On subgroup analyses in hospitalizations of patients with PR-AKI, blacks and Hispanics were more likely to have preeclampsia/eclampsia compared with whites (aOR, 1.29; 95% CI, 1.01 to 1.65; and aOR, 1.69; 95% CI, 1.23 to 2.31, respectively). Increased odds of mortality in PR-AKI compared with whites were only seen in black patients (aOR, 1.61; 95% CI, 1.02 to 2.55).
Conclusions: The incidence of PR-AKI has increased and the largest increase was seen in older patients and black patients. PR-AKI is associated with miscarriages, adverse discharge from hospital, and mortality. Black and Hispanic patients with PR-AKI were more likely to have adverse outcomes than white patients. Further research is needed to identify factors contributing to these discrepancies.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:1 |
|---|---|
| Enthalten in: |
Kidney360 - 1(2020), 3 vom: 26. März, Seite 169-178 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Beers, Kelly [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 07.04.2022 Date Revised 07.12.2022 published: Electronic-eCollection Citation Status MEDLINE |
|---|
| doi: |
10.34067/KID.0000102019 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM338985166 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM338985166 | ||
| 003 | DE-627 | ||
| 005 | 20231226001909.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.34067/KID.0000102019 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1129.xml |
| 035 | |a (DE-627)NLM338985166 | ||
| 035 | |a (NLM)35368630 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Beers, Kelly |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Racial and Ethnic Disparities in Pregnancy-Related Acute Kidney Injury |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 07.04.2022 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 by the American Society of Nephrology. | ||
| 520 | |a Background: Pregnancy-related AKI (PR-AKI) is increasing in the United States. PR-AKI is associated with adverse maternal outcomes. Disparities in racial/ethnic differences in PR-AKI by race have not been studied | ||
| 520 | |a Methods: This was a retrospective cohort study using the National Inpatient Sample (NIS) from 2005 to 2015. We identified patients who were admitted for a pregnancy-related diagnosis using the Neomat variable provided by the NIS database that indicates the presence of a maternal or neonatal diagnosis code or procedure code. PR-AKI was identified using ICD codes. Survey logistic regression was used for multivariable analysis adjusting for age, medical comorbidities, socioeconomic factors, and hospital/admission factors | ||
| 520 | |a Results: From 48,316,430 maternal hospitalizations, 34,001 (0.07%) were complicated by PR-AKI. Hospitalizations for PR-AKI increased from 3.5/10,000 hospitalizations in 2005 to 11.8/10,000 hospitalizations in 2015 with the largest increase seen in patients aged ≥35 and black patients. PR-AKI was associated with higher odds of miscarriage (adjusted odds ratio [aOR], 1.64; 95% CI, 1.34 to 2.07) and mortality (aOR, 1.53; 95% CI, 1.25 to 1.88). After adjustment for age, medical comorbidities, and socioeconomic factors, blacks were more likely than whites to develop PR-AKI (aOR, 1.17; 95% CI, 1.04 to 1.33). On subgroup analyses in hospitalizations of patients with PR-AKI, blacks and Hispanics were more likely to have preeclampsia/eclampsia compared with whites (aOR, 1.29; 95% CI, 1.01 to 1.65; and aOR, 1.69; 95% CI, 1.23 to 2.31, respectively). Increased odds of mortality in PR-AKI compared with whites were only seen in black patients (aOR, 1.61; 95% CI, 1.02 to 2.55) | ||
| 520 | |a Conclusions: The incidence of PR-AKI has increased and the largest increase was seen in older patients and black patients. PR-AKI is associated with miscarriages, adverse discharge from hospital, and mortality. Black and Hispanic patients with PR-AKI were more likely to have adverse outcomes than white patients. Further research is needed to identify factors contributing to these discrepancies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Abortion, Spontaneous | |
| 650 | 4 | |a Acute Kidney Injury | |
| 650 | 4 | |a Acute Kidney Injury and ICU Nephrology | |
| 650 | 4 | |a African Americans | |
| 650 | 4 | |a Hispanic Americans | |
| 650 | 4 | |a Hospitalization | |
| 650 | 4 | |a Pregnancy | |
| 650 | 4 | |a Racial Disparities | |
| 650 | 4 | |a Retrospective Studies | |
| 650 | 4 | |a Socioeconomic Factors | |
| 700 | 1 | |a Wen, Huei Hsun |e verfasserin |4 aut | |
| 700 | 1 | |a Saha, Aparna |e verfasserin |4 aut | |
| 700 | 1 | |a Chauhan, Kinsuk |e verfasserin |4 aut | |
| 700 | 1 | |a Dave, Mihir |e verfasserin |4 aut | |
| 700 | 1 | |a Coca, Steven |e verfasserin |4 aut | |
| 700 | 1 | |a Nadkarni, Girish |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Lili |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Kidney360 |d 2020 |g 1(2020), 3 vom: 26. März, Seite 169-178 |w (DE-627)NLM311083633 |x 2641-7650 |7 nnns |
| 773 | 1 | 8 | |g volume:1 |g year:2020 |g number:3 |g day:26 |g month:03 |g pages:169-178 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.34067/KID.0000102019 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 1 |j 2020 |e 3 |b 26 |c 03 |h 169-178 | ||