期刊
PLOS ONE
卷 11, 期 2, 页码 -出版社
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0148809
关键词
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资金
- Danish Heart Foundation
- Danish Kidney Foundation
- Department of Cardiology at Copenhagen University Hospital Gentofte
- Department of Nephrology at Copenhagen University Hospital Herlev
- Helen and Ejnar Bjoernows Foundation
- Danish Society of Nephrology
- Health Foundation
- Novo Nordisk Foundation
- Bristol-Myers Squibb
- Boehringer Ingelheim
- Lundbeck Foundation
- Capital Region of Denmark
- Novo Nordisk Fonden [NNF16OC0020224, NNF15OC0016230, NNF12OC1015957, NNF12OC1015904] Funding Source: researchfish
Introduction Dialysis-requiring acute kidney injury is a severe illness associated with poor prognosis. However, information pertaining to incidence rates and prevalence of risk factors remains limited in spite of increasing focus. We evaluate time trends of incidence rates and changing patterns in prevalence of comorbidities, concurrent medication, and other risk factors in nationwide retrospective cohort study. Materials and Methods All patients with dialysis-requiring acute kidney injury were identified between January 1st 2000 and December 31st 2012. By cross-referencing data from national administrative registries, the association of changing patterns in dialysis treatment, comorbidity, concurrent medication and demographics with incidence of dialysis-requiring acute kidney injury was evaluated. Results A total of 18,561 adult patients with dialysis-requiring AKI were identified between 2000 and 2012. Crude incidence rate of dialysis-requiring AKI increased from 143 per million (95% confidence interval, 137-144) in 2000 to 366 per million (357-375) in 2006, and remained stable hereafter. Notably, incidence of continuous veno-venous hemodialysis (CRRT) and use of acute renal replacement therapy in elderly >75 years increased substantially from 23 per million (20-26) and 328 per million (300-355) in 2000, to 213 per million (206-220) and 1124 per million (1076-1172) in 2012, respectively. Simultaneously, patient characteristics and demographics shifted towards increased age and comorbidity. Conclusions Although growth in crude incidence rate of dialysis-requiring AKI stabilized in 2006, continuous growth in use of CRRT, and acute renal replacement therapy of elderly patients >75 years, was observed. Our results indicate an underlying shift in clinical paradigm, as opposed to unadulterated growth in incidence of dialysis-requiring AKI.
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