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Severe Acute Kidney Injuries Rise Nationwide

Researchers find kidney injuries and deaths doubled in last decade (Dec. 6)

Severe acute kidney injuries are becoming more common in the U.S., increasing 10% per year and doubling over the last decade, according to a retrospective study conducted at the University of California—San Francisco (UCSF).

The study, published online in the Journal of the American Society of Nephrology, analyzed information from a national database that monitors all causes of hospitalizations and used these data to estimate the total number of acute kidney injuries in the U.S. that were sufficiently severe to require a patient to be placed on dialysis.

The results showed that these injuries — caused by such incidents as major infections, trauma, complications following surgery, and adverse drug reactions — increased by 10% per year from 2000 to 2009 (from 222 to 533 cases per million people). The study also showed that the total number of deaths associated with acute kidney injury more than doubled during that time, from 18,000 in 2000 to nearly 39,000 in 2009.

The researchers estimated that about 30% of the increase can be attributed to commonly known causes, such as the rise in severe infections, ventilator usage, acute heart failure, and cardiac catheterizations, over the same period. But doctors don’t know what else accounts for the rise in acute kidney injury and what hospitals can do to address the problem, according to UCSF nephrologist Dr. Raymond Hsu.

Composed of more than a million identical nephrons, which filter blood and produce urine, a single kidney can function even if a large part of it is damaged or shut down.

“Even if you were to lose 80% of your kidney function, you wouldn’t feel it,” said senior author Chi-yuan Hsu, MD. But once the insult to the kidneys becomes sufficiently severe to require a patient to go on dialysis, he said, the result is often fatal — about 20% of patients with acute kidney injury requiring dialysis in the study died.

Analyzing a decade’s worth of data and coming up with national statistics on acute kidney injury is a first step in discovering why this condition has been steadily rising and in developing measures to prevent them in the future, the team said.

“We hope that clinicians, researchers, and the general public can gain a higher appreciation of the devastating impact of acute kidney injury that is comparable to the near-universal, basic understanding of other forms of acute organ injury, such as heart attack and stroke,” Raymond Hsu said.

Source: UCSF; December 6, 2012.

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