Supplemental Table 1 Prior use of prescriptions with warning for patients with impaired renal function, £ 3 months prior to index admission in the outpatient setting
Nephrotoxic medicine, n (%) / Overall(n = 11,542) / CA-AKI
(n = 6,287) / HA-AKI
(n = 3,104) / Non-RIFLE AKI
(n = 2,151) / P value a
1. Analgesics / 3124 (27.07) / 1680 (26.72) / 873 (28.13) / 571 (26.55) / 0.296
2. Anti-microbial agents / 1950 (16.89) / 951 (15.13) / 659 (21.23) / 340 (15.81) / <.0001
3. Anti-epileptics / 194 (1.68) / 108 (1.72) / 45 (1.45) / 41 (1.91) / 0.424
4. Anti-hypertension / 4911 (42.55) / 3111 (49.48) / 1092 (35.18) / 708 (32.91) / <.0001
5. Contrast media / 210 (1.82) / 91 (1.45) / 85 (2.74) / 34 (1.58) / <.0001
6. Anti-hyperglycemia / 1678 (14.54) / 1165 (18.53) / 290 (9.34) / 223 (10.37) / <.0001
7. Immunosuppressants / 811 (7.03) / 541 (8.61) / 173 (5.57) / 97 (4.51) / <.0001
8. Urate-lowering agents / 755 (6.54) / 524 (8.33) / 147 (4.74) / 84 (3.91) / <.0001
9. Sulfasalazine and 5-aminosalicylate (5-ASA) / 19 (0.16) / 15 (0.24) / 2 (0.06) / 2 (0.09) / 0.098
10. Anticholinergic side effects of drugs / 2126 (18.42) / 1294 (20.58) / 508 (16.37) / 324 (15.06) / <.0001
11. Bisphosphonates / 80 (0.69) / 50 (0.8) / 16 (0.52) / 14 (0.65) / 0.296
12. Digoxin / 299 (2.59) / 186 (2.96) / 60 (1.93) / 53 (2.46) / 0.012
13. Lipid-lowering agents / 1364 (11.82) / 915 (14.55) / 253 (8.15) / 196 (9.11) / <.0001
14. Lithium / 6 (0.05) / 4 (0.06) / 1 (0.03) / 1 (0.05) / 0.815
15. Nitrates / 1328 (11.51) / 774 (12.31) / 341 (10.99) / 213 (9.9) / 0.006
16. Anti-thrombotic agents / 3330 (28.85) / 2027 (32.24) / 795 (25.61) / 508 (23.62) / <.0001
17. H2 blockers / 2788 (24.16) / 1716 (27.29) / 660 (21.26) / 412 (19.15) / <.0001
18. Pituitary and hypothalamic hormones and analogues (desmopressin, terlipressin, oxytocin, gonadorelin, somatostain, octreotide) / 199 (1.72) / 102 (1.62) / 66 (2.13) / 31 (1.44) / 0.113
19. Anti-parkinsonism / 61 (0.53) / 40 (0.64) / 13 (0.42) / 8 (0.37) / 0.212
Data are shown as number (percent of group) of patients in each group.
a. Statistically significant difference among CA-, HA- and non-RIFLE AKI groups by chi-square tests and Fisher exact tests for sample size < 5.
Abbreviations: AKI, acute kidney injury; CA-AKI, community-acquired acute kidney injury; HA-AKI, hospital-acquired acute kidney injury; RIFLE, risk, injury, failure, loss, and end stage of renal disease; non-RIFLE AKI, patients discharged with a diagnosis of AKI but not meeting the RIFLE criteria (i.e. SCr changes < 1.5 times).
Supplemental Table 2 Outcomes in patients with and without AKI
Adult Hospitalizations a / Patients with AKI dischargeOverall
(n=734,340) / Non-AKI a
(n=719,656 ) / AKI discharge a
(n=14,684) / Failure
(n=5,776) / Injury
(n=1,896) / Risk
(n=1,719) / Non-RIFLE AKI
(n=2,151)
Age on admission (years) / 57.48 ± 17.25 / 57.28± 17.2 / 67.42 ± 15.95 / 66.28 ± 15.67 / 69.18 ± 15.55 / 70.04 ± 15.19 / 68.37 ± 16.24
In-hospital mortality / 28,547 (3.89) / 24,450 (3.33) / 4,097 (27.9) / 2,035 (35.23) / 678 (35.76) / 527 (30.66) / 305 (14.18)
LOS (days) / 11.90± 19.63 / 11.66 ± 19.42 / 23.31 ± 25.59 / 26.44 ± 28.73 / 26.3 ± 26.74 / 24.6 ± 26.14 / 21.37 ± 19.99
Dialysis during hospitalization / 1,581 (0.22) / 1,330 (0.18) / 251 (1.71) / 118 (2.04) / 18 (0.95) / 19 (1.11) / 11 (0.51)
Data are shown as the mean (± standard deviation, SD) for age at admission, length of stay (LOS), and number (percent of group) of patients in each group.
a. Data are shown as hospitalizations for all adults, non-AKI, and AKI diagnosis at discharge
Abbreviations: AKI, acute kidney injury diagnosis at discharge; CA-AKI, community-acquired AKI; HA-AKI, hospital-acquired AKI; non-RIFLE AKI, patients with AKI discharge but not meeting the RIFLE criteria (i.e., SCr changes < 1.5 times); RIFLE, risk, injury, failure, loss, and end stage of renal disease.
Supplemental Table 3 Common discharge diagnoses accompanied by AKI in the study cohort
Discharge diagnosis / HA-AKI(n=3,104) / CA-AKI
(n = 6,287)
Unspecified septicemia / 1,070 / 34.47% / 1,939 / 30.84%
Hypopotassemia/Hyperpotassemia / 316 / 10.18% / 1,336 / 21.25%
Unspecified disorder of urethra and urinary tract / 326 / 10.50% / 1,335 / 21.23%
Acute respiratory failure / 1,074 / 34.60% / 1,304 / 20.74%
Unspecified hypertensive renal disease with renal failure / 366 / 11.79% / 1,227 / 19.52%
Chronic renal failure / 140 / 4.51% / 447 / 7.11%
Diabetes with renal/neurological manifestations / 258 / 8.31% / 975 / 15.51%
Pneumonia, organism unspecified / 613 / 19.75% / 875 / 13.92%
Other symptoms involving cardiovascular system / 439 / 14.14% / 765 / 12.17%
Heart failure, unspecified / 313 / 10.08% / 574 / 9.13%
Cirrhosis of liver without mention of alcohol / 290 / 9.34% / 551 / 8.76%
Malignant neoplasm of liver, primary / 227 / 7.31% / 365 / 5.81%
Secondary malignant neoplasm of liver / 181 / 5.83% / 269 / 4.28%
Other sequelae of chronic liver disease / 170 / 5.48% / 247 / 3.93%
Essential hypertension, unspecified / 65 / 2.09% / 350 / 5.57%
Coronary atherosclerosis of native coronary artery / 204 / 6.57% / 233 / 3.71%
Acute myocardial infarction of unspecified site / 179 / 5.77% / 210 / 3.34%
Bacterial pneumonia, unspecified / 159 / 5.12% / 185 / 2.94%
Data are shown as number (percent of group) of patients in each group.
Only those discharge diagnoses affecting > 5% patients with AKI at the time of discharge are shown.