Abstract P143: Racial Disparities In Acute Renal Failure Incidence Amidst Hypertensive Emergencies

Abstract

Introduction: Persons from diverse backgrounds are disproportionately affected by adverse outcomes related to hypertension. We aimed to examine the likelihood of requiring hemodialysis during hospitalization in patients admitted for hypertensive emergency by race. Methods: We analyzed the 2020 National Inpatient Sample data to evaluate patients primarily admitted for hypertensive emergencies and acutely required hemodialysis. Patients who were already on hemodialysis were excluded. To assess for correlations, we applied logistic and linear regression analyses, taking into account potential confounders. The threshold for statistical significance was established at a 2-tailed p-value <0.05. Results: In 2020, of 1,221,535 hypertensive emergency hospital admissions, 128,095 (10.5%) necessitated hemodialysis due to acute renal failure. After controlling for age, gender, hospital characteristics, insurance status, income, and Elixhauser comorbidities, we found that Black, Hispanic, Asian/Pacific Islander, and Native American patients had higher likelihoods of requiring hemodialysis compared to White patients, with aORs of 1.88 (95% CI 1.79-1.96), 2.96 (95% CI 2.74-3.19), 3.29 (95% CI 2.99-3.62), and 2.57 (95% CI 2.18-3.04) respectively (Figure 1). Conclusion: This analysis was unable to account for the degree of hypertension control prior to admission, a significant limitation. Further investigation is needed to discern what factors preceding or during hospital admission increase the risk of acute renal failure, in order to address these observed racial disparities in outcomes for patients with hypertensive emergencies.