title: Dialysis-Requiring Acute Kidney Injury in Denmark 2000-2012: Time Trends of Incidence and Prevalence of Risk Factors-A Nationwide Study.
abstract: BACKGROUND
  Dialysis-requiring acute kidney injury is a severe illness associated with poor prognosis. However, information pertaining to incidence rates and prevalence of risk factors remains limited in spite of increasing focus. We evaluate time trends of incidence rates and changing patterns in prevalence of comorbidities, concurrent medication, and other risk factors in nationwide retrospective cohort study.
  
  
  METHODS
  All patients with dialysis-requiring acute kidney injury were identified between January 1st 2000 and December 31st 2012. By cross-referencing data from national administrative registries, the association of changing patterns in dialysis treatment, comorbidity, concurrent medication and demographics with incidence of dialysis-requiring acute kidney injury was evaluated.
  
  
  RESULTS
  A total of 18,561 adult patients with dialysis-requiring AKI were identified between 2000 and 2012. Crude incidence rate of dialysis-requiring AKI increased from 143 per million (95% confidence interval, 137-144) in 2000 to 366 per million (357-375) in 2006, and remained stable hereafter. Notably, incidence of continuous veno-venous hemodialysis (CRRT) and use of acute renal replacement therapy in elderly >75 years increased substantially from 23 per million (20-26) and 328 per million (300-355) in 2000, to 213 per million (206-220) and 1124 per million (1076-1172) in 2012, respectively. Simultaneously, patient characteristics and demographics shifted towards increased age and comorbidity.
  
  
  CONCLUSIONS
  Although growth in crude incidence rate of dialysis-requiring AKI stabilized in 2006, continuous growth in use of CRRT, and acute renal replacement therapy of elderly patients >75 years, was observed. Our results indicate an underlying shift in clinical paradigm, as opposed to unadulterated growth in incidence of dialysis-requiring AKI.
authors: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Gentofte, Denmark.|Department of Nephrology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
authors: Nicholas
authors: N
authors: Carlson
authors: Department of Nephrology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
authors: Kristine
authors: K
authors: Hommel
authors: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Gentofte, Denmark.
authors: Jonas Bjerring
authors: JB
authors: Olesen
authors: Department of Cardiology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
authors: Anne-Merete
authors: AM
authors: Soja
authors: Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Gentofte, Denmark.
authors: Tina
authors: T
authors: Vilsbøll
authors: Department of Nephrology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors: Anne-Lise
authors: AL
authors: Kamper
authors: Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark.
authors: Christian
authors: C
authors: Torp-Pedersen
authors: Department of Cardiology, Gentofte Hospital, University of Copenhagen, Gentofte, Denmark.
authors: Gunnar
authors: G
authors: Gislason
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009369:Neoplasms / Q000453:epidemiology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012042:Registries; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors