Saha Manish K, Hogan Susan L, Falk Ronald J, Barnes Edward L, Hu Yichun, Kshirsagar Abhijit V, Thorpe Carolyn T
Division of Nephrology and Hypertension, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Division of Gastroenterology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Kidney Med. 2024 May 16;6(7):100836. doi: 10.1016/j.xkme.2024.100836. eCollection 2024 Jul.
RATIONALE & OBJECTIVE: About 25%-40% of patients with inflammatory bowel disease (IBD) may have extraintestinal manifestations, mainly involving the liver, skin, and joints. Kidney involvement in patients with IBD has been reported, but there are no estimates of its prevalence in population-based studies in the United States. We compared the frequency of acute kidney injury (AKI) among hospitalizations with IBD with that among hospitalizations with collagen vascular diseases and hospitalizations with neither condition.
Retrospective, population-based cohort study.
SETTING & PARTICIPANTS: Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database.
AKI and AKI requiring dialysis.
Regression models were used to compare the occurrence of AKI among groups. Inverse probability of treatment weighting was applied to balance groups on covariates.
The final sample comprised 5,735,804 hospitalizations, including 57,121 with IBD, 159,930 with collagen vascular diseases, and 5,518,753 with neither IBD nor collagen vascular diseases. AKI was observed in 13%, 15%, and 12.2% of hospitalizations with IBD, collagen vascular diseases, and the general population, respectively. When adjusting for demographic, hospital, and clinical characteristics using inverse probability of treatment weighting, hospitalizations with IBD had higher odds of being diagnosed with AKI than both those with collagen vascular diseases (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.27-1.38) and the general population (OR, 1.27; 95% CI, 1.23-1.31) and also had higher odds of being diagnosed with AKI requiring dialysis than those with collagen vascular diseases (OR, 1.59; 95% CI, 1.31-1.94) or than the general population (OR, 1.45; 95% CI, 1.25-1.68).
Cross-sectional analysis, underreporting of International Classification of Diseases codes, and analyses relevant to in-hospital stays only.
The prevalence and risk of AKI among hospitalizations with IBD is greater than that of hospitalizations with collagen vascular diseases and the general population. Coexisting kidney disease should be considered among patients with a known diagnosis of IBD.
约25%-40%的炎症性肠病（IBD）患者可能有肠外表现，主要累及肝脏、皮肤和关节。IBD患者的肾脏受累情况已有报道，但在美国基于人群的研究中尚无其患病率的估计。我们比较了IBD住院患者、胶原血管病住院患者以及无这两种疾病的住院患者中急性肾损伤（AKI）的发生频率。
基于人群的回顾性队列研究。
医疗保健成本与利用项目-全国住院患者样本数据库。
AKI以及需要透析的AKI。
使用回归模型比较各组中AKI的发生情况。应用治疗权重的逆概率来平衡各组的协变量。
最终样本包括5,735,804例住院患者，其中57,121例患有IBD，159,930例患有胶原血管病，5,518,753例既无IBD也无胶原血管病。IBD住院患者、胶原血管病住院患者和普通人群中分别有13%、15%和12.2%观察到AKI。在使用治疗权重的逆概率调整人口统计学、医院和临床特征后，IBD住院患者被诊断为AKI的几率高于胶原血管病住院患者（优势比[OR]，1.32；95%置信区间[CI]，1.27-1.38）和普通人群（OR，1.27；95%CI，1.23-1.31），并且被诊断为需要透析的AKI的几率也高于胶原血管病住院患者（OR，1.59；95%CI，1.31-1.94）或普通人群（OR，1.45；95%CI，1.25-1.68）。
横断面分析、国际疾病分类编码报告不足以及仅分析与住院期间相关的情况。
IBD住院患者中AKI的患病率和风险高于胶原血管病住院患者和普通人群。已知诊断为IBD的患者应考虑并存肾病。
