BACKGROUND Acute kidney injury (AKI) significantly increases morbidity and mortality for hospitalized children, yet sociodemographic risk factors for pediatric AKI are poorly described. We examined sociodemographic differences in pediatric AKI amongst a national cohort of hospitalized children. METHODS Secondary analysis of the most recent (2012) Kids' Inpatient Database (KID) from the Agency for Healthcare Research and Quality. Study sample weights were used to obtain national estimates of AKI (defined by administrative data). KID is a nationally representative sample of pediatric discharges throughout the USA. Linear risk regression models were used to assess the relationship between our primary exposures (race/ethnicity, health insurance, household urbanization, gender, and age) and the diagnosis of AKI, adjusting for comorbidities. RESULTS A total of 1,699,841 hospitalizations met our study criteria. In 2012, AKI occurred in approximately 12.3/1000 pediatric hospitalizations, which translates to almost 30,000 children nationally. Asian/Pacific Islander, African-American, and Hispanic children were at slightly increased risk for AKI compared to Caucasian children (adjusted risk difference (RD) 4.5 per 1000 hospitalizations, 95% confidence interval (CI) 2.9-6.0; 2.5/1000 hospitalizations, 95% CI 1.7-3.3; and 1.7/1000 hospitalizations, 95% CI 0.9-2.5, respectively). Uninsured children were more likely to suffer AKI compared to children with any health insurance (e.g., no insurance versus Medicaid: adjusted RD 14.4/1000 hospitalizations, 95% CI 12.7-16.2). Based on these national estimates, one episode of AKI might be prevented if 70 (95% CI 62-79) hospitalized children without insurance were provided with Medicaid. CONCLUSIONS Pediatric AKI occurs more frequently in racial minority and uninsured children, factors linked to lower socioeconomic status.

中文翻译：

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美国儿童急性肾损伤的种族和健康保险差异。


背景急性肾损伤（AKI）显着增加住院儿童的发病率和死亡率，但儿科 AKI 的社会人口学危险因素却很少被描述。我们研究了全国住院儿童队列中儿科 AKI 的社会人口统计学差异。方法 对医疗保健研究与质量机构最新（2012 年）儿童住院数据库 (KID) 进行二次分析。研究样本权重用于获得 AKI 的国家估计值（由管理数据定义）。 KID 是全美儿科出院样本的全国代表性样本。线性风险回归模型用于评估我们的主要暴露（种族/民族、健康保险、家庭城市化、性别和年龄）与 AKI 诊断之间的关系，并调整合并症。结果 共有 1,699,841 例住院患者符合我们的研究标准。 2012 年，AKI 发生在大约 12.3/1000 名儿童住院患者中，相当于全国近 30,000 名儿童。与白种人儿童相比，亚裔/太平洋岛民、非裔美国人和西班牙裔儿童发生 AKI 的风险略有增加（调整后风险差 (RD) 为每 1000 例住院患者 4.5，95% 置信区间 (CI) 2.9-6.0；2.5/1000 例住院患者） ，95% CI 1.7-3.3；和 1.7/1000 次住院，95% CI 0.9-2.5）。与有任何健康保险的儿童相比，未投保的儿童更容易患 AKI（例如，没有保险与医疗补助：调整后的 RD 14.4/1000 次住院治疗，95% CI 12.7-16.2）。根据这些国家估计，如果向 70 名（95% CI 62-79）没有保险的住院儿童提供医疗补助，则可以预防一次 AKI 发作。 结论 儿童 AKI 在少数族裔和未投保儿童中更常见，这些因素与较低的社会经济地位有关。