Journal article
The Detrimental Impact of End-Stage Kidney Disease Is Not Reflected in Autopsy Reports
Archives of pathology & laboratory medicine (1976), Vol.148(1), pp.74-77
01/01/2024
DOI: 10.5858/arpa.2022-0338-OA
PMID: 37014976
Abstract
End-stage kidney disease (ESKD) is defined as renal impairment requiring renal replacement therapy to sustain life. With a 1-year mortality of ∼20% to 30%, many die of complications related to this disease.
To determine the percentage of autopsy cases of decedents with ESKD in which the contribution of ESKD to death is accurately reflected in the final report.
Autopsy case records were retrospectively reviewed at 4 institutions (Yale New Haven Hospital, University of Chicago Medical Center, University of Illinois at Chicago Hospital, University of Iowa Hospital). Clinical, macroscopic, and microscopic autopsy findings were reviewed, with attention to renal disease findings.
One hundred sixty decedents with documented ESKD and premortem dialysis were identified who underwent autopsy assessment. ESKD was implicated as a cause of death (CoD) or significant contributing factor in 44 cases (28%), but not in the remaining 116 cases (72%). Cardiovascular disease was the most common CoD in ESKD. There was significant interpathologist variation in the inclusion of ESKD as a CoD across institutions. These rates ranged from 85% correlation (23 of 27 cases), to 13% (4 of 31 and 8 of 62 cases at 2 institutions), and 22.5% (9 of 40 cases) across the 4 participating institutions.
The recognition at autopsy of ESKD as a CoD or contributing CoD at autopsy in patients undergoing dialysis remains low (28%). The detrimental impact of ESKD is not reflected in hospital autopsy reports, which carries implications for collection of vital statistics and allocation of research funding for kidney diseases.
Details
- Title: Subtitle
- The Detrimental Impact of End-Stage Kidney Disease Is Not Reflected in Autopsy Reports
- Creators
- Gabriel B Lerner - Yale UniversityMeredith A Reynolds - University of ChicagoSuman Setty - University of Illinois at ChicagoReem Deeb - University of Illinois at ChicagoPrerna Rastogi - University of IowaGilbert Moeckel - Yale UniversityHarold Sanchez - Yale UniversityKammi J Henriksen - University of ChicagoAnthony Chang - University of Chicago
- Resource Type
- Journal article
- Publication Details
- Archives of pathology & laboratory medicine (1976), Vol.148(1), pp.74-77
- DOI
- 10.5858/arpa.2022-0338-OA
- PMID
- 37014976
- eISSN
- 1543-2165
- Language
- English
- Electronic publication date
- 04/05/2023
- Date published
- 01/01/2024
- Academic Unit
- Pathology
- Record Identifier
- 9984386252002771
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