Intern Med J. 2025 Dec 27. doi: 10.1111/imj.70301. Online ahead of print.
ABSTRACT
BACKGROUND: Incidence estimates of acute kidney injury (AKI) in Australia are frequently based on episodes of admitted care. Jurisdiction-wide patient-level linked analysis can better define the epidemiology of AKI.
AIMS: Outline the incidence and prevalence of AKI and the outcomes associated with an admission complicated by AKI.
METHODS: Retrospective data-linkage analysis using the Victorian Death Index, Cancer Registry, Integrated Non-Admitted Health and Admitted Episode datasets, examining adult, acute, overnight inpatient admissions in Victoria, Australia from July 2016 to June 2017. AKI episodes were identified using ICD-10-AM codes. The initial AKI episode marked the index admission, with a 36-month look-back and 36-month follow-up for comorbidity and outcomes. Primary outcomes were the incidence and prevalence of AKI. Secondary analyses examined readmission rates, the development of new morbidity and mortality, including causes of death.
RESULTS: The incidence of AKI was 10.8% (95% confidence interval (CI): 10.7%-10.8%), with higher rates in the elderly, overseas-born and comorbid patients. The prevalence of AKI was 1.1 cases per 100 annually. The inpatient mortality rate was 5.2% and was associated with Indigenous status (odds ration (OR) 1.81, 95% CI: 1.31-2.50), higher comorbidity burden (OR 3.97, 95% CI: 3.46-4.55), age ≥ 65 (OR 1.24, 95% CI: 1.07-1.43) and aged care facility residence (OR 2.32, 95% CI: 1.81-2.98). Among survivors of an index admission, 70.4% were readmitted within 12 months and 43.3% experienced recurrent AKI. Mortality was 23.2% at 12 months and 39.8% at 36 months, primarily attributed to cancer (26.0%) and cardiovascular disease (20.8%).
CONCLUSIONS: This jurisdiction-wide, patient-level study demonstrates a high prevalence of AKI, incidence and mortality, highlighting it as a public health issue.
PMID:41454763 | DOI:10.1111/imj.70301