DOI: 10.1097/shk.0000000000002753 ISSN: 1540-0514

Factors Associated with Acute Kidney Injury and Clinical Outcomes in Patients with Renal and Perinephric Abscess: A National Inpatient Sample Analysis (2016–2022)

Xiaocong Wu, Yanfei Wang, Junfen Cheng, Jian Wang, Boqi Geng, Junde Mo, Guorong Zhong, Binbin Tian

Background:

Patients diagnosed with renal and perinephric abscesses (RPA) frequently experience acute kidney injury (AKI), which is associated with poor clinical outcomes. However, large-scale, nationwide studies examining factors associated with AKI in this patient population are lacking.

Objectives:

The current research aimed to identify factors associated with AKI in patients with RPA.

Methods:

A retrospective cohort study was conducted using data obtained from the National Inpatient Sample database spanning January 1, 2016, through December 31, 2022. The primary outcome assessed was the development of AKI. To identify factors associated with AKI, we performed multivariable logistic regression analysis.

Results:

In total, 4,896 patients (32.1%) developed AKI during hospitalization, with the occurrence rising from 29.9% in 2016 to 34.8% by 2022. Multivariable logistic regression revealed several factors associated with AKI, such as age ≥45 years, male sex, Black race, comorbidities (acquired immune deficiency syndrome, coagulopathy, fluid and electrolyte disorders, obesity and chronic kidney disease excluding end-stage renal disease), and complications (hyperkalemia, acute respiratory failure, arrhythmia, gastrointestinal hemorrhage, pneumonia, blood transfusion, urinary tract infection). Patients with AKI were associated with longer median hospital stays (9 vs . 5 days), higher median costs ($82,741 vs. $43,282), increased mortality (5.0% vs. 0.9%), and greater use of mechanical ventilation (3.4% vs . 0.9%), dialysis (4.8% vs . 0.8%), and percutaneous nephrostomy drainage (32.4% vs. 25.6%) ( P < 0.001).

Conclusions:

AKI commonly occurs among patients with RPA and is significantly associated with worse outcomes, highlighting the critical need for early risk assessment and prompt interventions.

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