AKI is a major public health problem with frequent recurrences, high levels of readmissions, and substantial mortality, a Victoria-wide data linkage analysis has shown.

Speaking at the ANZSN ASM, Dr Zena Barakat presented results from a 3-year look-back and 3-year follow-up from first admissions with an ICD-10-AM code for AKI between July 2016 and June 2017. Patients with end-stage kidney disease were excluded.

The study found 7% of all multi-day hospitalisations in acute, adult units were caused or complicated by AKI. The population prevalence of AKI was 1.1 per 100 Victorian adults per annum.

Patient-level data from 38,033 adults showed a high incidence in the elderly (median age 72 years), people born overseas, and those with comorbidities (median Charlson comorbidity score of 6). Patients also had a median of two hospitalisations in the 12 months prior to the index admission.

Dr Barakat, an advanced trainee at Northern Health, said most patients (94.8%) survived the index admissions but the AKI was relapsing and recurring.

“70.4% were readmitted within 12 months of the index admission, and in fact, 43.3% had a recurrence of AKI.”

The leading diagnoses on the first readmissions were diabetes, AKI, and heart failure.

She said within 36 months of the first admission, 34.9% of patients had a new diagnosis of kidney disease and 40.0% a new diagnosis of cardiovascular disease.

Mortality was substantial rising from 27.2% at 12 months to 30.7% at 24 months and 37.7% at 36 months.

Patients who died were more likely to be Indigenous, have a high comorbidity score and come from a residential aged care facility.

The study also showed that the leading cause of death at 36 months was cancer (26.0%) followed by cardiovascular disease (20.8%). These new diagnoses typically occurred in patients ≥65 years of age.

Dr Barakat noted the previously reported 3-year survival for patients on dialysis was 72% compared to the 3-year survival of 62.3% in this study of AKI.

“This is an Australian-first, jurisdiction-wide, patient-level data… I’d really like to show you today that AKI is a major public health problem,” she said.

The study suggested the need for improved education, interventional studies, and policies reflecting the epidemiology of AKI and focusing on interactions with cancer, readmissions, and mortality,

Dr Barakat was the recipient of the ANZSN 2024 Shaun Summers Clinical Trainee Award for her presentation.