J Korean Med Sci.  2023 Aug;38(31):e239. 10.3346/jkms.2023.38.e239.

Temporal Trend of the Incidence and Characteristics of Renal Infarction: Korean Nationwide Population Study

• Kim DE
• Moon I
• Park S
• Park M
• Park S
• Kwon SS
• Kong MG
• Park HW
• Choi HO
• Seo HS
• Cho YH
• Lee NH
• Suh J

• KMID: 2544958
• DOI: http://doi.org/10.3346/jkms.2023.38.e239

Abstract

Background
Large-scale studies about epidemiologic characteristics of renal infarction (RI) are few. In this study, we aimed to analyze the incidence and prevalence of RI with comorbidities in the South Korean population.
Methods
We investigated the medical history of the entire South Korean adult population between 2013 and 2019 using the National Health Insurance Service database (n = 51,849,591 in 2019). Diagnosis of RI comorbidities were confirmed with International Classification of Disease, Tenth Revision, Clinical Modification codes. Epidemiologic characteristics, distribution of comorbidities according to etiologic mechanisms, and trend of antithrombotic agents were estimated.
Results
During the 7-years, 10,496 patients were newly diagnosed with RI. The incidence rate increased from 2.68 to 3.06 per 100,000 person-years during the study period. The incidence rate of RI increased with age peaking in the 70s with 1.41 times male predominance. The most common comorbidity was hypertension, followed by dyslipidemia and diabetes mellitus. Regarding etiologic risk factor distribution, high embolic risk group, renovascular disease group, and hypercoagulable state group accounted for 16.6%, 29.1%, and 13.7% on average, respectively. For the antithrombotic treatment of RI, the prescription of antiplatelet agent gradually decreased from 17.0% to 13.0% while that of anticoagulation agent was maintained around 35%. The proportion of non-vitamin K antagonist oral anticoagulants remarkably increased from only 1.4% to 17.6%.
Conclusion
Considering the progressively increasing incidence of RI and high prevalence of coexisting risk factors, constant efforts to raise awareness of the disease are necessary. The current epidemiologic investigation of RI would be the stepping-stone to establishing future studies about clinical outcomes and optimal treatment strategies.

Keyword

Renal Infarction; Incidence; National Health Insurance Service (NHIS); South Korea

Figure

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  Fig. 1 Flow chart of subjected patients.CT = computer tomography, MRI = magnetic resonance imaging, USG = ultrasonography.

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  Fig. 2 Incidence rate of renal infarction according to gender.

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  Fig. 3 Incidence rate of renal infarction stratified by age subgroup in 2013–2019.

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  Fig. 4 Distribution of comorbidity and etiology of renal infarction.HTN = hypertension, DM = diabetes mellitus, MI = myocardial infarction, IHD = ischemic heart disease, TIA = transient ischemic attack, PAD = peripheral arterial disease.

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  Fig. 5 Temporal trend of oral antithrombotic therapy of renal infarction.NOAC = non-vitamin K antagonist oral anticoagulant.

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