NKF 2019—Pregnancy-related acute kidney injury: Hospitalizations higher in African Americans

  • Richard Robinson
  • Conference Reports
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  • The rate of hospitalization for pregnancy-related acute kidney injury (Pr-AKI) has risen across all major racial/ethnic groups.
  • Blacks were disproportionately affected by Pr-AKI compared with Whites and Hispanics.

Why this matters

  • The rate of Pr-AKI has tripled from 1993 to 2014, but racial differences have not been studied.
  • Pr-AKI is associated with multiple adverse pregnancy outcomes, including preterm labor, miscarriage, and death.

Study design

  • Data were drawn from the National Inpatient Sample, the largest publicly available all-payer inpatient care database in the United States, from 2005 to 2014.
  • Hospitalizations for pregnancy and Pr-AKI were determined by ICD codes.
  • Logistical regression was performed for age, income, hospital type, and comorbidities.

Key results

  •  7058 Pr-AKI cases were identified among 9,768,905 pregnancy hospitalizations.
  • Hospitalizations for Pr-AKI rose from 0.04% of all pregnancies in 2005 to 0.12% in 2015, but from 0.07% to 0.3% over the same period for Blacks.
  • Blacks accounted for 29% of patients with Pr-AKI, vs 12.4% of non-AKI patients.
    • Whites: 32.6% Pr-AKI, 43.8% non-AKI.
    • Hispanics: 15.8% Pr-AKI, 19.2% non-AKI (P<.0001 for effect of race>
  • Pr-AKI was more common in older women, those of lower socioeconomic status, and those with comorbidities (diabetes, hypertension, obesity, anemia, pulmonary circulation disorders; all P<.0001>


  • NIS database excludes some hospital types.
  • Not all clinical details are captured.

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