WIP 53 - National Estimates of AKI and Dialysis in Pediatric Patients with Heart Disease 1997-2019

Publication Number: WIP 53.7421

Sanjana Venkat, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States; Alexander J. Kula, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States

Background: Acute kidney injury (AKI) and AKI requiring dialysis (AKI+D) are highly prevalent in pediatric patients admitted with heart disease. Yet, little is known whether the rates of AKI have changed over time in youth admitted with heart disease. Furthermore, patient or provider-level characteristics that underlie potential differences in incidence over time have not been described.

Objective: The purpose of this study was to characterize and describe longitudinal trends in the rates of AKI and AKI-D in pediatric patients with heart disease or admitted for cardiovascular procedures using a nationally representative dataset of pediatric admissions.

Design/Methods: We analyzed data from the Kids Inpatient Database (KID), the largest public pediatric inpatient care database in the United States, from 1997 to 2019. AKI was identified using International Classification of Diseases Clinical Modification (ICD-CM) codes, 9th Revision (1997-2012) and 10th Revision (2016-2019). Use of dialysis during hospitalization was assessed using ICD-CM procedure codes. Patients admitted for uncomplicated birth or with chronic dialysis requirement were excluded. Preliminarily, KID data from 1997-2019 included 21,538,095 unweighted discharges after applying exclusion criteria and the unweighted number of admissions with AKI increased from 597 to 1737 nationwide during this time. Admissions with a primary cardiovascular diagnosis are available from 2006-2019. Works in progress include identifying all patients with acquired or congenital heart disease, those undergoing cardiovascular surgery, and generating weighted results. Lastly, outcome data including length of stay and mortality will be described over time. Sampling data included with KID allows for weighting to generate accurate national-estimates of yearly-incidence and rates of selected diagnoses. Longitudinal changes will be described using jointpoint analysis. This study has been reviewed by the Lurie IRB and was deemed exempt, and the work is currently underway and will be ready by January 2025.