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Pyogenic Liver Abscess is Associated With Increased Risk of Acute Kidney Injury: A Nationwide Population-Based Cohort
Chih-Chien Sung1, Chin-Sheng Lin, Shih-Hua Lin
1From the Division of Nephrology (C-CS, S-HL), Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei; Graduate Institute of Life Science (C-CS), National Defense Medical Center, Taipei; Division of Cardiology (C-SL), Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei; Management Office for Health Data (C-LL), China Medical University Hospital, Taichung; College of Medicine (C-LL), China Medical University, Taichung; Department of Neurology (K-MJ), Lu-Tung Christian Hospital, Changhua; School of Public Health (K-MJ), Chung Shan Medical University, Taichung (K-MJ); Graduate Institute of Clinical Medical Science and School of Medicine (C-HK), College of Medicine, China Medical University, Taichung; and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung, Taiwan.
Abstract:
The aim of this large population-based cohort study was to determine whether pyogenic liver abscess (PLA) is associated with the risk of acute kidney injury (AKI).A total of 31,815 patients aged 20 years or older diagnosed with PLA for the first time during hospitalization between 2000 and 2011 were included in a PLA cohort, and 127,620 age- and sex-matched patients without PLA were included in a non-PLA cohort. The incidence and the risk of the first attack of AKI at the end of 2011 were measured. Cox proportional hazard regression models were used to analyze the risk of AKI.In mean follow-up periods of 4.36 and 4.94 years for the PLA and non-PLA cohorts, respectively, the overall incidence of AKI was 1.51-fold greater in the PLA cohort than in the non-PLA cohort (9.25 vs 6.11 events per 1000 person-years; 95% confidence intervals [CIs] = 1.42-1.61). After we controlled for potential confounding factors, the adjusted hazard ratio (aHR) of AKI was 1.36 (95% CIs = 1.27-1.46) for the PLA cohort compared with the non-PLA cohort. Moreover, among patients without comorbidities, the risk of AKI remained higher in the PLA cohort compared with the non-PLA cohort (aHR: 1.91, 95% CIs = 1.59-2.29).This study suggests that PLA associates with an increased risk of AKI. Clinicians should be aware of the potential risk of AKI after diagnosis of PLA.
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