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Cited by 46Acute Kidney Injury ResearchChronic Kidney Disease and DiabetesDialysis and Renal Disease Management

US Trends in Hospitalizations for Dialysis-Requiring Acute Kidney Injury in People With Versus Without Diabetes

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Harding, Jessica Lee, Li, Yanfeng, Burrows, Nilka Ríos, Bullard, Kai McKeever, Pavkov, Meda E.·2020·American Journal of Kidney Diseases
DOI 10.1053/j.ajkd.2019.09.012PMC PMC11000252
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Abstract

Rationale & objective Dialysis-requiring acute kidney injury (AKI-D) has increased substantially in the United States. We examined trends in and comorbid conditions associated with hospitalizations and in-hospital mortality in the setting of AKI-D among people with versus without diabetes. Study design Cross-sectional study. Setting & participants Nationally representative data from the National Inpatient Sample and National Health Interview Survey were used to generate 16 cross-sectional samples of US adults (aged ≥18 years) between 2000 and 2015. Exposure Diabetes, defined using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes. Outcome AKI-D, defined using ICD-9-CM diagnosis and procedure codes. Analytical approach Annual age-standardized rates of AKI-D and AKI-D mortality were calculated for adults with and without diabetes, by age and sex. Data were weighted to be representative of the US noninstitutionalized population. Trends were assessed using join point regression with annual percent change (Δ/y) reported. Results In adults with diabetes, AKI-D increased between 2000 and 2015 (from 26.4 to 41.1 per 100,000 persons; Δ/y, 3.3%; P < 0.001), with relative increases greater in younger versus older adults. In adults without diabetes, AKI-D increased between 2000 and 2009 (from 4.8 to 8.7; Δ/y, 6.5%; P < 0.001) and then plateaued. AKI-D mortality significantly declined in people with and without diabetes. In adults with and without diabetes, the proportion of AKI-D hospitalizations with liver, rheumatic, and kidney disease comorbid conditions increased between 2000 and 2015, while the proportion of most cardiovascular comorbid conditions decreased. Limitations Lack of laboratory data to corroborate AKI diagnosis; National Inpatient Sample data are hospital-level rather than person-level data; no data for type of diabetes; residual unmeasured confounding. Conclusions Hospitalization rates for AKI-D have increased considerably while mortality has decreased in adults with and without diabetes. Hospitalization rates for AKI-D remain substantially higher in adults with diabetes. Greater AKI risk-factor mitigation is needed, especially in young adults with diabetes.

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  • The rates of hospitalizations for AKI requiring dialysis are five times higher in adults with diabetes compared with adults without diabetes (risk ratio 5.0; 95% CI 4.8-5.1).

    “The rates of hospitalizations for AKI requiring dialysis are five times higher in adults with diabetes compared with adults without diabetes (risk ratio 5.0; 95% CI 4.8-5.1)(28).”

    From 11. Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2026 (2026) · cites this paper as [28]

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Authors
Harding, J. L., Li, Y., Burrows, N. R., Bullard, K. M., & Pavkov, M. E.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Harding, Jessica Lee
ORCID
Venue
American Journal of Kidney Diseases
Publisher
Elsevier BV
Published
2020-06
Volume
75
Issue
6
Pages
897-907
ISSN
0272-6386 (ISSN-L)
DOI
10.1053/j.ajkd.2019.09.012
PMC
PMC11000252
OpenAlex
W2994622851
Cited by
46
References
40
Citations by year
2026: 2 · 2025: 6 · 2024: 11 · 2023: 8 · 2022: 8 · 2021: 6 · 2020: 3 · 2019: 1
FWCI
3.48
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Kidney Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Nephrology › Acute Kidney Injury Research
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
Keywords
diabetes mellitus, hospitalization trends, in-hospital mortality, comorbidities, cardiovascular comorbidity, liver disease, young adults, United States adults, National Inpatient Sample, National Health Interview Survey, ICD-9-CM codes, age-standardized rates
MeSH terms
Age Factors, Cross-Sectional Studies, Diabetes Mellitus, Female, Renal Dialysis, Hospitalization, Humans, Male, Middle Aged, Risk Factors, Sex Factors, United States, Comorbidity, Incidence, Hospital Mortality, Outcome Assessment, Health Care, Acute Kidney Injury

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