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Regional variation in incidence and prognosis of acute kidney injury

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Titel: Regional variation in incidence and prognosis of acute kidney injury
Autoren: Simon Kok Jensen, Thomas Bøjer Rasmussen, Bjarke Hejlskov Jacobsen, Uffe Heide-Jørgensen, Simon Sawhney, Henrik Gammelager, Henrik Birn, Søren Paaske Johnsen, Christian Fynbo Christiansen
Quelle: Jensen, S K, Rasmussen, T B, Jacobsen, B H, Heide-Jørgensen, U, Sawhney, S, Gammelager, H, Birn, H, Johnsen, S P & Christiansen, C F 2024, 'Regional variation in incidence and prognosis of acute kidney injury', Nephrology, Dialysis, Transplantation, vol. 39, no. 7, gfad267, pp. 1171-1180. https://doi.org/10.1093/ndt/gfad267
Jensen, S K, Rasmussen, T B, Jacobsen, B H, Heide-Jørgensen, U, Sawhney, S, Gammelager, H, Birn, H, Johnsen, S P & Christiansen, C F 2024, 'Regional variation in incidence and prognosis of acute kidney injury', Nephrology Dialysis Transplantation, vol. 39, no. 7, pp. 1171-1180. https://doi.org/10.1093/ndt/gfad267
Verlagsinformationen: Oxford University Press (OUP), 2023.
Publikationsjahr: 2023
Schlagwörter: Male, Adult, Aged, 80 and over, Incidence, Denmark, Acute Kidney Injury, Middle Aged, Prognosis, Denmark/epidemiology, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, acute kidney injury, Risk Factors, incidence, Humans, Female, prognosis, variation, Renal Insufficiency, Chronic, Renal Insufficiency, Chronic/epidemiology, Acute Kidney Injury/epidemiology, chronic kidney disease, Aged, Follow-Up Studies
Beschreibung: Background Examining regional variation in acute kidney injury (AKI) and associated outcomes may reveal inequalities and possibilities for optimization of the quality of care. Using the Danish medical databases, we examined regional variation in the incidence, follow-up and prognosis of AKI in Denmark. Methods Patients with one or more AKI episodes in 2017 were identified using population-based creatinine measurements covering all Danish residents. Crude and sex-and-age-standardized incidence rates of AKI were estimated using census statistics for each municipality. Adjusted hazard ratios (aHR) of chronic kidney disease (CKD), all-cause death, biochemical follow-up and outpatient contact with a nephrology department after AKI were estimated across geographical regions and categories of municipalities, accounting for differences in demographics, comorbidities, medication use, lifestyle and social factors, and baseline kidney function. Results We identified 63 382 AKI episodes in 58 356 adults in 2017. The regional standardized AKI incidence rates ranged from 12.9 to 14.9 per 1000 person-years. Compared with the Capital Region of Denmark, the aHRs across regions ranged from 1.04 to 1.25 for CKD, from 0.97 to 1.04 for all-cause death, from 1.09 to 1.15 for biochemical follow-up and from 1.08 to 1.49 for outpatient contact with a nephrology department after AKI. Similar variations were found across municipality categories. Conclusions Within the uniform Danish healthcare system, we found modest regional variation in AKI incidence. The mortality after AKI was similar; however, CKD, biochemical follow-up and nephrology follow-up after AKI varied across regions and municipality categories.
Publikationsart: Article
Dateibeschreibung: application/pdf
Sprache: English
ISSN: 1460-2385
0931-0509
DOI: 10.1093/ndt/gfad267
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/38140955
https://vbn.aau.dk/da/publications/dee86ddc-d65d-46e0-a444-37691daf453c
http://www.scopus.com/inward/record.url?scp=85197089952&partnerID=8YFLogxK
https://vbn.aau.dk/ws/files/638229847/Jensen_et_al._2023_._Regional_variation_in_incidence_and_prognosis_of_acute_kidney_injury.pdf
https://doi.org/10.1093/ndt/gfad267
https://pure.au.dk/portal/en/publications/91912c1b-e241-482f-bcf1-b67fa0f59a1b
http://www.scopus.com/inward/record.url?scp=85197089952&partnerID=8YFLogxK
https://doi.org/10.1093/ndt/gfad267
Rights: OUP Standard Publication Reuse
Dokumentencode: edsair.doi.dedup.....ca8a0c5c6ac3f261bedc12befe455898
Datenbank: OpenAIRE
Beschreibung
Abstract:Background Examining regional variation in acute kidney injury (AKI) and associated outcomes may reveal inequalities and possibilities for optimization of the quality of care. Using the Danish medical databases, we examined regional variation in the incidence, follow-up and prognosis of AKI in Denmark. Methods Patients with one or more AKI episodes in 2017 were identified using population-based creatinine measurements covering all Danish residents. Crude and sex-and-age-standardized incidence rates of AKI were estimated using census statistics for each municipality. Adjusted hazard ratios (aHR) of chronic kidney disease (CKD), all-cause death, biochemical follow-up and outpatient contact with a nephrology department after AKI were estimated across geographical regions and categories of municipalities, accounting for differences in demographics, comorbidities, medication use, lifestyle and social factors, and baseline kidney function. Results We identified 63 382 AKI episodes in 58 356 adults in 2017. The regional standardized AKI incidence rates ranged from 12.9 to 14.9 per 1000 person-years. Compared with the Capital Region of Denmark, the aHRs across regions ranged from 1.04 to 1.25 for CKD, from 0.97 to 1.04 for all-cause death, from 1.09 to 1.15 for biochemical follow-up and from 1.08 to 1.49 for outpatient contact with a nephrology department after AKI. Similar variations were found across municipality categories. Conclusions Within the uniform Danish healthcare system, we found modest regional variation in AKI incidence. The mortality after AKI was similar; however, CKD, biochemical follow-up and nephrology follow-up after AKI varied across regions and municipality categories.
ISSN:14602385
09310509
DOI:10.1093/ndt/gfad267