Anemia at hospital admission and the severity of Acute Kidney Injury Open Access

Abstract

Background: Acute Kidney Injury (AKI) is a common complication of hospitalized patient s that is associated with increase in hospital cost, length of stay and mortality. It is frequently associated with anemia. We seek to determine if anemia at hospital admission is associated with increased severity of AKI.

Methods: This was a retrospective chart review of all adult admissions with AKI during 2011 at a tertiary hospital. Cases of AKI were identified based on diagnosis code. Excluded were cases with chronic kidney disease. AKI was defined as an increase in serum creatinine of at least 0.3 mg/dl and classified into levels of severity as mild (increase in serum creatinine by 0.3-0.5), moderate (increase in serum creatinine by 0.5-1.0) and severe (increase in serum creatinine greater than 1.0). Anemia was defined as hemoglobin of less than 10 g/dl.

Results: There were 454 patients with 495 admissions in which AKI was one of the discharge diagnoses during 2011. 421 patients had single admissions while 33 patients had multiple admissions ranging from 2-4 admissions. Anemia was not associated with increased severity of AKI or dialysis. Anemia was however significantly associated with a two times increased odds of death in the unadjusted model (OR 2.01 95% CI 1.31-3.10). The presence of malignancy modified this association. Patients who had malignancy in addition to anemia and AKI had almost a 4 times increased odds of death at 3.61 (95% CI 1.75-7.47) while those without malignancy but with AKI and anemia had no increased odds of death OR 0.94 (95% CI 0.49-1.80). There was also a trend towards an increase in length of stay in anemic patients at admission. Lower hemoglobin, Black race and diabetes were factors associated with multiple admissions for AKI. Having multiple admissions for AKI was also significantly associated with increased odds of requiring dialysis.

Table of Contents

1. Introduction page 1
2. Literature Review page 4
3. Methods page 6
4. Results page 8
5. Discussion page 10
6. Conclusion page 12
7. References page 14
8. Tables and Figures page 16

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Keyword	anemia acute kidney injury acute renal failure
Committee Chair / Thesis Advisor	McClellan, William, Emory University
Committee Members	Holley, Jean, Carle Physician Group, University of Illinois at Urbana-Champaign
Partnering Agencies	Hospital or other health care provider

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