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, Simon Kok Jensen Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus , Denmark Department of Clinical Medicine, Aarhus University , Aarhus , Denmark Correspondence to: Simon Kok Jensen; E-mail: skj@clin.au.dk; Twitter/X handle: @simonkokjensen, @DCEAarhus Search for other works by this author on: Oxford Academic Thomas Bøjer Rasmussen Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus , Denmark Department of Clinical Medicine, Aarhus University , Aarhus , Denmark Search for other works by this author on: Oxford Academic Bjarke Hejlskov Jacobsen Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus , Denmark Department of Clinical Medicine, Aarhus University , Aarhus , Denmark Search for other works by this author on: Oxford Academic Uffe Heide-Jørgensen Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus , Denmark Department of Clinical Medicine, Aarhus University , Aarhus , Denmark Search for other works by this author on: Oxford Academic Simon Sawhney Aberdeen Centre for Health Data Science, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen , Aberdeen , UK NHS Grampian , Aberdeen , UK Search for other works by this author on: Oxford Academic Henrik Gammelager Department of Intensive Care Medicine, Aarhus University Hospital , Aarhus , Denmark Search for other works by this author on: Oxford Academic Henrik Birn Department of Clinical Medicine, Aarhus University , Aarhus , Denmark Department of Biomedicine, Aarhus University , Aarhus , Denmark Department of Renal Medicine, Aarhus University Hospital , Aarhus , Denmark Search for other works by this author on: Oxford Academic Søren Paaske Johnsen Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University , Aalborg , Denmark Search for other works by this author on: Oxford Academic Christian Fynbo Christiansen Department of Clinical Epidemiology, Aarhus University Hospital , Aarhus , Denmark Department of Clinical Medicine, Aarhus University , Aarhus , Denmark Search for other works by this author on: Oxford Academic
https://orcid.org/0000-0002-0032-131X Nephrology Dialysis Transplantation, Volume 39, Issue 7, July 2024, Pages 1171–1180, https://doi.org/10.1093/ndt/gfad267
Published:
22 December 2023
Article history
Received:
11 August 2023
Published:
22 December 2023
Corrected and typeset:
15 March 2024
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Simon Kok Jensen, Thomas Bøjer Rasmussen, Bjarke Hejlskov Jacobsen, Uffe Heide-Jørgensen, Simon Sawhney, Henrik Gammelager, Henrik Birn, Søren Paaske Johnsen, Christian Fynbo Christiansen, Regional variation in incidence and prognosis of acute kidney injury, Nephrology Dialysis Transplantation, Volume 39, Issue 7, July 2024, Pages 1171–1180, https://doi.org/10.1093/ndt/gfad267
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ABSTRACT
Background
Examining regional variation in acute kidney injury (AKI) and associated outcomes may reveal inequalities and possibilities for optimization of the quality of care. Using the Danish medical databases, we examined regional variation in the incidence, follow-up and prognosis of AKI in Denmark.
Methods
Patients with one or more AKI episodes in 2017 were identified using population-based creatinine measurements covering all Danish residents. Crude and sex-and-age-standardized incidence rates of AKI were estimated using census statistics for each municipality. Adjusted hazard ratios (aHR) of chronic kidney disease (CKD), all-cause death, biochemical follow-up and outpatient contact with a nephrology department after AKI were estimated across geographical regions and categories of municipalities, accounting for differences in demographics, comorbidities, medication use, lifestyle and social factors, and baseline kidney function.
Results
We identified 63382 AKI episodes in 58356 adults in 2017. The regional standardized AKI incidence rates ranged from 12.9 to 14.9 per 1000 person-years. Compared with the Capital Region of Denmark, the aHRs across regions ranged from 1.04 to 1.25 for CKD, from 0.97 to 1.04 for all-cause death, from 1.09 to 1.15 for biochemical follow-up and from 1.08 to 1.49 for outpatient contact with a nephrology department after AKI. Similar variations were found across municipality categories.
Conclusions
Within the uniform Danish healthcare system, we found modest regional variation in AKI incidence. The mortality after AKI was similar; however, CKD, biochemical follow-up and nephrology follow-up after AKI varied across regions and municipality categories.
Graphical Abstract
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acute kidney injury, chronic kidney disease, incidence, prognosis, variation
© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
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