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Acute kidney injury (AKI) occurs more often among older patients and men with drug overdose–involved hospitalizations, while severe inpatient courses disproportionately affect younger patients, according to research published in the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Noting that overdose mortality has declined recently in the United States, Sola Han, Pharm.D., Ph.D., from the CDC in Atlanta, and colleagues examined whether serious, nonfatal complications, including AKI, have followed similar trends.

The researchers found that AKI was documented in 34.5% of 1,297,847 drug overdose–involved hospitalizations. The percentage of patients with AKI was 28.2%, 37.4%, 29.4% and 38.1% among those aged 24 years and younger, those aged 65 years and older, women and men, respectively. Among patients with a drug overdose–involved hospitalization, AKI increased during 2016 to 2022 (annual percentage change [APC], 2.69%) and decreased during 2022 to 2025 (APC, −5.11%).

Overall, 60.9% of patients with a drug overdose–involved hospitalization and AKI experienced a severe inpatient course, including 68.1%, 56.1%, 61.9% and 60.4% of those 24 years and younger, those 65 years and older, women and men, respectively. There was an increase in the percentage of drug overdose–involved hospitalizations with a severe inpatient course during 2016 to 2023, followed by a decrease during 2023 to 2025 (APCs, 1.82% and −2.89%, respectively).

"Public health efforts focusing on preventing drug overdose to reduce subsequent AKI risk, promoting early recognition of kidney injury, and improving continuity of kidney care after hospitalization might reduce the occurrence of drug overdose–involved AKI," the authors write.

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