Masao Iwagami1,2, Hidekazu Moriya3, Kent Doi4, Hideo Yasunaga2, Rei Isshiki5, Izumi Sato6,7, Yasuhiro Mochida3, Kunihiro Ishioka3, Takayasu Ohtake3, Sumi Hidaka3, Eisei Noiri5, Shuzo Kobayashi3. 1. Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. 2. Department of Clinical Epidemiology and Health Economics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 3. Department of Nephrology, Immunology, and Vascular Medicine, Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kanagawa, Japan. 4. Department of Emergency and Critical Care Medicine, University of Tokyo Hospital, Tokyo, Japan. 5. Department of Nephrology and Endocrinology, University of Tokyo Hospital, Tokyo, Japan. 6. Center for Pharmacoepidemiology and Treatment Science, Rutgers, The State University of New Jersey, NJ, USA. 7. Department of Pharmacoepidemiology, Kyoto University, Kyoto, Japan.
Abstract
Background: Understanding disease seasonality is important for improving clinical practice, hospital resource utilization and community-based preventive care. However, no studies have investigated the seasonality of acute kidney injury (AKI). Methods: In the Tokushukai Medical Database, which includes 38 Japanese community hospitals, we identified hospitalized patients with AKI based on the Kidney Disease: Improving Global Outcomes serum creatinine criteria from January 2012 to December 2014. We plotted the number and proportion of patients with AKI among hospitalized patients by month of hospital admission. Subgroup analyses were conducted by the admission diagnosis category, timing of AKI diagnosis and age. We also examined the association between month of hospital admission and AKI, adjusting for patient characteristics and AKI risk factors. Finally, we assessed seasonal variations in disease severity and 30-day mortality of patients with AKI. Results: We identified 81 279 (14.6%) patients with AKI among 555 940 hospitalized patients. The proportion of patients with AKI was highest in January (16.7%) and lowest in June (13.4%). Subgroup analyses suggested that the seasonality of AKI incidence was driven by community-acquired AKI associated with the admission diagnosis of cardiovascular and pulmonary diseases among older patients. The adjusted odds ratio for AKI (January versus June) was 1.24 (95% confidence interval, 1.17-1.31). Patients with AKI showed a larger number of failing organs in winter, and their 30-day mortality was 16.4% in spring, 14.5% in summer, 15.6% in autumn and 18.4% in winter. Conclusion: AKI is more common among hospitalized patients and patients with AKI are more severely ill in winter.
Background: Understanding disease seasonality is important for improving clinical practice, hospital resource utilization and community-based preventive care. However, no studies have investigated the seasonality of acute kidney injury (AKI). Methods: In the Tokushukai Medical Database, which includes 38 Japanese community hospitals, we identified hospitalized patients with AKI based on the Kidney Disease: Improving Global Outcomes serum creatinine criteria from January 2012 to December 2014. We plotted the number and proportion of patients with AKI among hospitalized patients by month of hospital admission. Subgroup analyses were conducted by the admission diagnosis category, timing of AKI diagnosis and age. We also examined the association between month of hospital admission and AKI, adjusting for patient characteristics and AKI risk factors. Finally, we assessed seasonal variations in disease severity and 30-day mortality of patients with AKI. Results: We identified 81 279 (14.6%) patients with AKI among 555 940 hospitalized patients. The proportion of patients with AKI was highest in January (16.7%) and lowest in June (13.4%). Subgroup analyses suggested that the seasonality of AKI incidence was driven by community-acquired AKI associated with the admission diagnosis of cardiovascular and pulmonary diseases among older patients. The adjusted odds ratio for AKI (January versus June) was 1.24 (95% confidence interval, 1.17-1.31). Patients with AKI showed a larger number of failing organs in winter, and their 30-day mortality was 16.4% in spring, 14.5% in summer, 15.6% in autumn and 18.4% in winter. Conclusion: AKI is more common among hospitalized patients and patients with AKI are more severely ill in winter.
Authors: Gurmukteshwar Singh; Yirui Hu; Steven Jacobs; Jason Brown; Jason George; Maria Bermudez; Kevin Ho; Jamie A Green; H Lester Kirchner; Alex R Chang Journal: Kidney360 Date: 2021-07-13
Authors: Gianmarco Lombardi; Giovanni Gambaro; Nicoletta Pertica; Alessandro Naticchia; Matteo Bargagli; Pietro Manuel Ferraro Journal: Environ Health Date: 2021-01-15 Impact factor: 5.984