Gastrointestinal Hemorrhage in Acute Kidney Injury Occurs Predominately in Men

Orlando—There are few epidemiological data available on the number of annual hospitalizations, variations in demographics, healthcare-related costs, and outcomes for patients with acute kidney injury (AKI) who experience gastrointestinal hemorrhage. Shantanu Solanki, MD, and colleagues recently conducted an analysis of data from the National Inpatient Sample (NIS) database to examine outcomes among that patient population. Results of the analysis were reported during a poster session at the NKF 2017 Spring Clinical Meetings in a poster titled Trend Analysis of Gastrointestinal Hemorrhage in Patients with Acute Kidney Injury.

The researchers identified all patients discharged with an International Classification of Diseases, Ninth Revision diagnosis code for AKI during 2001 to 2011. Following the identification of patients with AKI at discharge, the researchers then searched the database to identify patients with a discharge diagnosis of hemodialysis and gastrointestinal hemorrhage. The Cochran-Armitage trend test was utilized to determine statistical significance.

The database search revealed 19,393,811 hospitalizations involving AKI. Of those, 7.35% (n=1,424,692) received hemodialysis (group 1), and 92.65% (n=17,969,119) did not receive hemodialysis (group 2), (P<.0001). The trend for the number of discharges for both groups increased; however, there was a significant rise in the total number of discharges of patients not receiving hemodialysis over the study period (P<.001).

In group 1, gastrointestinal hemorrhage was reported as a discharge diagnosis in 5.32% (n=75,735), compared with 3.31% (n=594,680) of group 2 (P<.001). The most common age group affected by gastrointestinal hemorrhage with AKI in group 1 included patients 65 to 79 years of age (37.3%); the most common age group experiencing gastrointestinal hemorrhage with AKI in group 2 were patients ≥80 years of age (35.4%) (P<.001).

In both groups, male sex was predominately affected (P=.006 for group 1 and P<.001 for group 2). The healthcare-related costs of care for group 1 increased over the study period, with an average of $61,463 (adjusted for inflation) (P<.0001); the costs for patients in group 2 decreased in trend over time, with an average of $28,419 (P<.001).

Trends for all-cause mortality showed significant decline for both groups (P<.0001); overall mortality was 38.07% for group 1 and 25.05% for group 2 (P<.001).

Source: Solanki S, Haq K, Gupta S, Sao R, Sule S, Chugh S. Trend analysis of gastrointestinal hemorrhage in patients with acute kidney disease. Abstract of a poster presented at the National Kidney Foundation 2017 Spring Clinical Meetings, April 19-22, 2017, Orlando, Florida.