The Expanding Burden of Acute Kidney Injury in California: Impact of the Epidemic of Diabetes on Kidney Injury Hospital Admissions.
Alvaro Medel-Herrero, Diane Mitchell, Sally Moyce and 2 others
PMID 31872993WHAT IT FOUND
California acute kidney injury episodes rose from 25,495 in 2005 to 48,845 in 2015, especially in people with diabetes or hypertension.
County records showed higher kidney injury admissions where diabetes was more common.
Key findings
01California acute kidney injury episodes rose from 25,495 in 2005 to 48,845 in 2015, while total hospitalizations for all conditions fell from 3,990,255 to 3,833,043.
02Diabetes or hypertension was recorded in 83.3% of the 410,109 acute kidney injury episodes, and most of the increase in AKI hospitalizations was in patients with these conditions.
03County acute kidney injury rates were higher where diabetes was more common, and the link strengthened over time.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used diagnosis codes, not laboratory creatinine results, so some acute kidney injury cases may be misclassified. It could not analyse hypertension trends because the needed data were missing. It cannot show that diabetes caused acute kidney injury, only that the two were common together. Coding of coexisting conditions may have changed over time and could inflate comorbidity counts.
The easy way to misread this
Do not read the rising AKI numbers as proof that diabetes caused AKI or that a nursing intervention would reduce it. The study analysed hospital records over time and could not separate diagnosis coding, other conditions, and treatment changes.