THE ECONOMIC CONSEQUENCES OF ACUTE KIDNEY INJURY IN INTENSIVE CARE UNIT AT A TERTIARY CENTRE IN MALAYSIA: A PROSPECTIVE COST-EFFECTIVENESS ANALYSIS

7 Feb 2025 12 a.m. 12 a.m.
WCN25-AB-1174, Poster Board= FRI-040

Introduction:

Acute kidney injury (AKI) is common among hospitalized patients, even more in those who require intensive care unit (ICU) admission. AKI in hospitalized patients results in a longer duration of hospital stay, dialysis dependence, and significantly higher mortality especially among the critically ill patients.

Methods:

A prospective observational study of patients who were admitted to ICU. The cost-effectiveness analysis of management of AKI in ICU patients was done by calculating the costs of kidney replacement therapy (KRT), ICU stay, and overall hospitalization, and Years of Life Lost (YLL).

Results:

310 patients were enrolled in this study. 49.4% of patients had AKI during the hospitalization. Sequential organ failure assessment (SOFA) score was an independent risk factor for AKI development and KRT requirement. Among ICU patients with AKI, early KRT resulted in a higher cost spent on dialysis (RM 1000.00) but can reduce the costs of ICU stay (- RM 2125.00) and overall hospitalization (- RM 5972.50). A delay in KRT for AKI in ICU patients beyond 24 hours of Nephrology referral resulted in significant YLL of 9.9 years.

Outcome

Early KRT

Delayed KRT

Incremental

Total costs, RM

Dialysis cost, RM

Cost of ICU stay, RM

8002.00

2760.00

2000.00

13974.50

1760.00

4125.00

-5972.50

1000.00

-2125.00

Years of Life Lost

0

9.9

-9.9

Figure 1. ROC curve analysis for SOFA score to predict AKIFigure 2. ROC curve analysis for SOFA score to predict KRT requirement

Conclusions:

AKI occurs in nearly half of patients admitted to ICU, leading to poorer outcomes and higher treatment cost. Among ICU patients with AKI who require KRT, early KRT is most cost-effective. Hence, it is utmost important to recognize the need of KRT in ICU patients with AKI. SOFA score plays an important role to predict AKI development and KRT requirement in ICU patients.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.