#6584 weekend effect in acute kidney injury admissions and 1-year renal outcome

Abstract Background and Aims The “weekend effect” is the finding of worse outcomes in hospital admissions occurring over weekends. The reasons for this are still unclear but shorter staffing has been suggested to contribute. Little is known about the impact of the “weekend effect” on renal outcomes. We aim to analyze the impact of the weekend effect on patients admitted with acute kidney injury (AKI). We evaluated one-year renal outcome and mortality in patients admitted for AKI over weekends and weekdays. Method We conducted a retrospective analysis of all adult patients admitted in a tertiary medical center in Portugal over a period of 6 months with a diagnosis of AKI. Variables were retrieved using clinical and laboratory data. AKI was defined and severity was accessed according to Kidney Disease Improving Global Outcomes classification. Patients were categorized according to weekdays or weekend admission. Outcomes were in-hospital mortality, hemodialysis (HD) requirement and one-year mortality. Statistical significance was defined as a P-value <0.05 Results We included 163 patients with mean age of 69.8±16.2 years and 52.7% were male. The majority of patients were admitted on weekdays (74.2%, n = 121). Also, the majority had AKI stage 3 (65.6%, n = 107). Forty eight patients (29.4%) required HD during hospitalization and in-hospital mortality was 24.5%. There were no significant differences in HD requirement (31.4% vs 23.8%, p = 0.434), mortality (25.6% vs 21.4%, p = 0.680) nor HD requirement at discharge (25.6% vs 26.2%, p = 0.681) between weekday or weekend admissions. Of the 123 patients discharged, during the one-year follow-up 30.1% (n = 37) died and 7.3% (n = 9) required HD. There were no differences between weekdays or weekend admissions concerning mortality (32.2% vs 24.2%, p = 0,507) and HD requirement (7.8% vs 6.1%, p = 0,746) Conclusion In this cohort of patients with AKI there was no “weekend effect”, which reflects the adequacy of care independently of the day of admission. The retrospective design with a limited number of patients may have influenced the results. Further studies focusing on renal outcomes are required to better understand the occurence of the weekend effect and its long-term impact.