INCREASING TRENDS AND UNFAVORABLE OUTCOMES OF ACUTE KIDNEY INJURY AMONG PATIENTS WITH PULMONARY HYPERTENSION: A NATIONWIDE ANALYSIS

Abstract

SESSION TITLE: PAH with ComplicationsSESSION TYPE: Rapid Fire Original InvPRESENTED ON: 10/17/2022 12:15 pm - 1:15 pmPURPOSE: Cardiorenal syndrome is an established risk factor for acute kidney injury (AKI). No contemporary data is available for assessing pulmonary hypertension as an independent risk factor for AKI. We aimed to identify the burden, trends, and outcomes of AKI in pulmonary hypertension hospitalized patients.METHOD: Using National Inpatient Sample (2016-2019, ICD10 codes), we identified hospitalizations with pulmonary heart disease and diseases of pulmonary circulation (PHDPC, 18-90 years) and divided them into AKI and non-AKI. Odds and yearly trend of AKI in PHDPC, demographics, comorbidities, and outcomes for hospitalization between 2 cohorts were analyzed.RESULTS: PHDPC (6,000,000) hospitalizations had 28.3% AKI. Odds of AKI for PDHPC were significantly higher on univariate (OR 2.46, 95CI 2.44-2.48) and multivariate (OR 1.15, 95CI 1.14-1.16) analysis. AKI increased from 23% in 2016 to 27.2% in 2019 in PDHPC (ptrend<0.001). AKI patients were significantly older (mean, 71.3 vs 68.1 years), had higher proportion of males (47.7 vs 42.5%), blacks (20.8 vs 18.4%), Medicare-enrollees (75.1 vs 69.6%), large, urban-teaching, Midwest and West region hospitalizations, non-electively admissions than non-AKI. AKI cohort had significantly higher hyperlipidemia, obesity, prior CABG/MI/PCI, CHF, arrhythmia, valvular disease, PVD, complicated hypertension, neurological disorders, complicated diabetes, hypothyroidism, renal failure, liver disease, peptic ulcer disease, lymphoma, coagulopathy, weight loss, fluid/electrolyte disorders, blood loss anemia, deficiency anemia, and alcohol abuse. All-cause mortality (10.2 vs 3.3%), LOS (mean, 9.2 vs 5.8 days), adjusted charges (median, 64158 vs 41910 USD) were significantly higher in AKI than non-AKI. Univariate (OR 3.38, 95CI 3.32-3.45) and multivariate (OR 2.53, 95CI 2.48-2.58) analysis revealed significantly higher odds of mortality in AKI than in non-AKI in PDHPC (ptrend<0.001).CONCLUSIONS: Nearly one-fourth PDHPC present with concurrent AKI and worsening renal function.CLINICAL IMPLICATIONS: Increased risk of AKI in PDHPC, with poor outcomes, warrants extra vigilant care for patients having concomitant risk factors for AKI.DISCLOSURES: No relevant relationships by Thomas Alukalno disclosure on file for Shilp Arora;no disclosure on file for Behnam Bozorgnia;No relevant relationships by Rupak DesaiNo relevant relationships by Sohiel DeshpandeNo relevant relationships by Akhil JainNo relevant relationships by VIRALKUMAR PATEL SESSION TITLE: PAH with Complications SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: Cardiorenal syndrome is an established risk factor for acute kidney injury (AKI). No contemporary data is available for assessing pulmonary hypertension as an independent risk factor for AKI. We aimed to identify the burden, trends, and outcomes of AKI in pulmonary hypertension hospitalized patients. METHOD: Using National Inpatient Sample (2016-2019, ICD10 codes), we identified hospitalizations with pulmonary heart disease and diseases of pulmonary circulation (PHDPC, 18-90 years) and divided them into AKI and non-AKI. Odds and yearly trend of AKI in PHDPC, demographics, comorbidities, and outcomes for hospitalization between 2 cohorts were analyzed. RESULTS: PHDPC (6,000,000) hospitalizations had 28.3% AKI. Odds of AKI for PDHPC were significantly higher on univariate (OR 2.46, 95CI 2.44-2.48) and multivariate (OR 1.15, 95CI 1.14-1.16) analysis. AKI increased from 23% in 2016 to 27.2% in 2019 in PDHPC (ptrend<0.001). AKI patients were significantly older (mean, 71.3 vs 68.1 years), had higher proportion of males (47.7 vs 42.5%), blacks (20.8 vs 18.4%), Medicare-enrollees (75.1 vs 69.6%), large, urban-teaching, Midwest and West region hospitalizations, non-electively admissions than non-AKI. AKI cohort had significantly higher hyperlipidemia, obesity, prior CABG/MI/PCI, CHF, arrhythmia, valvular disease, PVD, complicated hypertension, neurological disorders, complicated diabetes, hypothyroidism, renal failure, liver disease, peptic ulcer disease, lymphoma, coagulopathy, weight loss, fluid/electrolyte disorders, blood loss anemia, deficiency anemia, and alcohol abuse. All-cause mortality (10.2 vs 3.3%), LOS (mean, 9.2 vs 5.8 days), adjusted charges (median, 64158 vs 41910 USD) were significantly higher in AKI than non-AKI. Univariate (OR 3.38, 95CI 3.32-3.45) and multivariate (OR 2.53, 95CI 2.48-2.58) analysis revealed significantly higher odds of mortality in AKI than in non-AKI in PDHPC (ptrend<0.001). CONCLUSIONS: Nearly one-fourth PDHPC present with concurrent AKI and worsening renal function. CLINICAL IMPLICATIONS: Increased risk of AKI in PDHPC, with poor outcomes, warrants extra vigilant care for patients having concomitant risk factors for AKI. DISCLOSURES: No relevant relationships by Thomas Alukal no disclosure on file for Shilp Arora; no disclosure on file for Behnam Bozorgnia; No relevant relationships by Rupak Desai No relevant relationships by Sohiel Deshpande No relevant relationships by Akhil Jain No relevant relationships by VIRALKUMAR PATEL