D Phillips1, J Holmes2, R Davies2, J Geen3,4, J D Williams1, A O Phillips1. 1. Institute of Nephrology, Cardiff University School of Medicine, Cardiff, UK. 2. Welsh Renal Clinical Network, Cwm Taf University Health Board, Merthyr, UK. 3. Department of Clinical Biochemistry, Cwm Taf University Health Board, Merthyr, UK. 4. Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
Abstract
AIM: Although socioeconomic background is known to impact on the incidence and progression of chronic kidney disease, its influence of on the presentation and outcome for acute kidney injury is not known and is the subject of this study. DESIGN: The Welsh National electronic AKI reporting system was used to identify all cases of AKI in patients >18 years of age between March 2015 and November 2017. METHODS: Socioeconomic classification of patients was derived from the Welsh Index Multiple Deprivation score (WIMD). Patients were grouped according to the WIMD score by their postcode, and the ranked data were categorized into percentiles and correlated with incidence and measures of AKI severity and outcome. RESULTS: Date was collected on a total of 57 654 patients. Increased deprivation was associated with higher AKI incidence rates, more episodes of AKI per patient and more severe AKI at presentation. In contrast 90-day mortality was highest in the most affluent areas. Mortality in affluent areas was driven by increased patient age. Corrected for age 90-day mortality was higher in areas of increased deprivation. CONCLUSION: This study highlights that AKI incidence presentation and outcomes are adversely affected by social deprivation. Further studies are required to understand the extent to which these differences reflect patient related factors or regional differences in provision and access to care.
AIM: Although socioeconomic background is known to impact on the incidence and progression of chronic kidney disease, its influence of on the presentation and outcome for acute kidney injury is not known and is the subject of this study. DESIGN: The Welsh National electronic AKI reporting system was used to identify all cases of AKI in patients >18 years of age between March 2015 and November 2017. METHODS: Socioeconomic classification of patients was derived from the Welsh Index Multiple Deprivation score (WIMD). Patients were grouped according to the WIMD score by their postcode, and the ranked data were categorized into percentiles and correlated with incidence and measures of AKI severity and outcome. RESULTS: Date was collected on a total of 57 654 patients. Increased deprivation was associated with higher AKI incidence rates, more episodes of AKI per patient and more severe AKI at presentation. In contrast 90-day mortality was highest in the most affluent areas. Mortality in affluent areas was driven by increased patient age. Corrected for age 90-day mortality was higher in areas of increased deprivation. CONCLUSION: This study highlights that AKI incidence presentation and outcomes are adversely affected by social deprivation. Further studies are required to understand the extent to which these differences reflect patient related factors or regional differences in provision and access to care.
Authors: Erin F Barreto; Diana J Schreier; Heather P May; Kristin C Mara; Alanna M Chamberlain; Kianoush B Kashani; Shannon L Piche; Chung-Il Wi; Sandra L Kane-Gill; Victoria T Smith; Andrew D Rule Journal: Am J Nephrol Date: 2021-11-02 Impact factor: 3.754
Authors: Charalampos Loutradis; Luke Pickup; Jonathan P Law; Indranil Dasgupta; Jonathan N Townend; Paul Cockwell; Adnan Sharif; Pantelis Sarafidis; Charles J Ferro Journal: Biol Sex Differ Date: 2021-04-08 Impact factor: 5.027