THE INCIDENCE OF PATIENTS WITH ACUTE KIDNEY DISEASE REQUIRING DIALYSIS HAS INCREASED OVER THE PAST 16 YEARS, BUT MORTALITY TRENDS SHOW DECLINE

 

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THE INCIDENCE OF PATIENTS WITH ACUTE KIDNEY DISEASE REQUIRING DIALYSIS HAS INCREASED OVER THE PAST 16 YEARS, BUT MORTALITY TRENDS SHOW DECLINE

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Mai
Ots-Rosenberg
Anne-Grethe Tuisk annegrethe.tuisk@gmail.com University of Tartu Clinical Medicine Tartu Estonia -
Anne Kuudeberg anne.kuudeberg@ut.ee University of Tartu Bio and Translational Medicine Tartu Estonia -
Jana Uhlinova jana.uhlinova@kliinikum.ee University of Tartu Clinical Medicine Tartu Estonia -
Marek Eerme marek.eerme@kliinikum.ee Tartu University Hospital Anesthesiology and intensive care Tartu Estonia -
Peeter Tähepõld peeter.tahepold@kliinikum.ee Tartu University Hospital Anesthesiology and intensive care Tartu Estonia -
Mai Ots-Rosenberg mai.rosenberg@kliinikum.ee University of Tartu Clinical Medicine Tartu Estonia *
 
 
 
 
 
 
 
 
 

The prevalence of acute kidney injury (AKI) has increased over decades and mortality remains high, but recent trends are unclear. The International Society of Nephrology (ISN) launched the “0by25” initiative in 2013, with the aim of reducing preventable deaths from AKI by 2025. AKI patients requiring dialysis are hospitalized for more than 7 days, so all of these patients can be considered as acute kidney disease (AKD) patients.

The aim of the study was to assess the trends in the incidence and in-hospital mortality of dialysis-requiring patients with AKD in a university hospital over three periods.

A retrospective cohort study analyzed dialysis-requiring patients with AKD who were hospitalized in 2009–2011 (period I), 2019–2023 (period II) and 2024 )period III). Demographic data, AKD incidence, and treatment outcomes were compared. Data were collected from electronic medical records. Descriptive statistics methods were used to analyze the data. The study has been approved by the Human Research Ethics Committee of the University of Tartu (protocol 384/M-20, meeting 20.11.2023).

In period I, 318 CKD patients (65.1% men, mean age 61.3 ± 15.7 years for men, 62.7 ± 16.5 years for women) received dialysis treatment. In period II, there were 1493 (57.1% men, mean age 60.6 ± 15.5 years for men, 62.3 ± 16.0 years for women). The mean age of the patients remained almost stable, but the proportion of women increased. The number of AKD patients requiring dialysis increased from 106 (period I) to 299 (period II) per year i.e. 3 times. The proportion of patients requiring dialysis in intensive care units decreased from 67.6% to 42.3%, while increasing from 19.8% to 50.7% in the nephrology department. In-hospital mortality decreased significantly: in period I it was 33.4% (106 deaths), in period II it was 20.7% (309 deaths). And in period III, 294 patients with AKD required dialysis, and the in-hospital mortality rate was even lower, 19.0%.

In our university hospital, the number of patients with chronic kidney disease requiring dialysis increased approximately 3-fold over a 16-year period, while in-hospital mortality decreased significantly. Such a long-term study shows a significant increase in the incidence of chronic kidney disease (CKD) today. In line with the “0by25” initiative, we have been able to demonstrate the successful treatment of patients with CKD, as reflected in a decrease in mortality.

The results of the study have been partially presented at the 2025 annual conference of the Faculty of Medicine of the University of Tartu.

Kewords