P0926 - Outcomes of Patients Hospitalized With Crohn's Disease and Concurrent Acute Kidney Injury: A Propensity Score-Matched Study from a U.S. Collaborative Network

Karecia Byfield, MBBS¹, Phuuwadith Wattanachayakul, MD¹, Evan Isaacs, DO², Tinsae Anebo, MD¹, Nino Gudushauri, MD³, Megan Johnson, MBBS⁴, Colton F. Jones, MBBS¹, Jordan Carty, MD¹, James Walter, MD^2
1Albert Einstein Medical Center, Philadelphia, PA; ²Einstein Healthcare Network, Philadelphia, PA; ³Jefferson Einstein Hospital, Philadelphia, PA; ⁴Spanish Town Hospital, Kingston, Saint Andrew, Jamaica

Introduction: Renal and urinary tract complications such as nephrolithiasis, entero-vesical fistulas and kidney injury are complications that occur in patients with Crohn's disease and may have bidirectional interactions with disease severity. However, there is a scarcity of data regarding the influence of concurrent acute kidney injury (AKI) on the outcomes among patients hospitalized with Crohn's disease. Considering these concerns, we aim to explore this relationship using a national-level database.

Methods: We analysed data for this retrospective, observational cohort study from the US Collaborative Network - TriNetX. We divided patients with Crohn's disease into two groups: those with and without AKI. The AKI group was propensity score-matched with the control group based on age, sex, race and comorbidities. Then, we followed these patients for 60 days to assess outcomes, including all-cause mortality, readmission rates, risk of pulmonary edema, ICU admission rates, risk of gastrointestinal bleeding and need for transfusion of blood products. Kaplan-Meier survival curve analysis was utilised to analyse these outcomes.

Results: After propensity-score matching, each cohort consisted of 8505 patients. Baseline characteristics were similar, with the AKI group averaging 54.2 years and the non-AKI group 55.0 years. Both cohorts were 50% female. The ethnicity distribution was as follows: White (74%), followed by Black (12%) and Hispanic (3%) in both cohorts. Our analysis found that within 60 days post-hospitalization, patients with Crohn's and comorbid AKI had a significantly higher risk of all-cause mortality (HR: 8.45, 95% CI: 6.82-10.49, P< 0.005), readmission (HR: 1.92, 95% CI: 1.56-2.37, P< 0.001), pulmonary edema (HR: 10.53, 95% CI: 6.57-16.89, P< 0.001) and ICU admission (HR: 7.96, 95% CI: 6.33-10.01, P< 0.005). Additionally, there was a significantly elevated need for transfusion of blood products in patients with concurrent AKI (HR: 2.99, 95% CI: 2.51- 3.56, P< 0.003) but no significant difference in the occurrence of gastrointestinal bleed and need for dialysis.

Discussion: Our study found that concurrent AKI in patients with Crohn's disease is linked to increased risks of mortality, readmission and various systemic complications. Further longitudinal cohort studies are necessary to explore the relationship between different stages of AKI and associated outcomes and prevention strategies to enhance patient outcomes.


Disclosures:


Karecia Byfield, MBBS¹, Phuuwadith Wattanachayakul, MD¹, Evan Isaacs, DO², Tinsae Anebo, MD¹, Nino Gudushauri, MD³, Megan Johnson, MBBS⁴, Colton F. Jones, MBBS¹, Jordan Carty, MD¹, James Walter, MD². P0926 - Outcomes of Patients Hospitalized With Crohn's Disease and Concurrent Acute Kidney Injury: A Propensity Score-Matched Study from a U.S. Collaborative Network, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.