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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice

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Predictors for early readmission in patients hospitalized with new onset pediatric lupus nephritis

Angel Ah Guerra1, Rouba Garro2, Courtney McCracken3

  • 1Department of Pediatrics, Division of Pediatric Allergy, Immunology and Rheumatology, 426490University of California Davis, Sacramento, CA, USA.

Lupus
|September 17, 2021
PubMed

Insights

Pediatric lupus nephritis readmissions occur in 17% of children within 30 days. Avoiding intravenous pulse methylprednisolone and albumin-assisted diuresis may reduce early pediatric lupus nephritis hospital readmissions.

Area of Science:

  • Pediatric Nephrology
  • Rheumatology
  • Hospital Readmission Research

Background:

  • Pediatric lupus nephritis (LN) is a severe manifestation of childhood-onset systemic lupus erythematosus.
  • Early hospital readmissions in pediatric LN can indicate suboptimal management and impact patient outcomes.
  • Understanding risk factors for 30-day readmissions is crucial for improving care transitions.

Purpose of the Study:

  • To determine the 30-day hospital readmission rate in children with new-onset lupus nephritis.
  • To identify risk factors associated with early readmissions in this vulnerable pediatric population.

Main Methods:

  • Retrospective analysis of 76 children hospitalized with new-onset lupus nephritis between 2008 and 2017.
  • Calculation of the 30-day hospital readmission rate.
  • Univariable and multivariable analyses to compare readmitted versus non-readmitted patients.

Main Results:

  • The 30-day readmission rate was 17.1%.
  • Factors associated with readmission included male gender, not receiving pulse steroids, diuretic treatment, albumin infusions, stage 2 hypertension, higher white blood cell count, non-ACE antihypertensive drugs, and NSAID use at discharge.
  • Multivariable analysis identified lack of intravenous pulse methylprednisolone (IVMP) and albumin-assisted diuresis for hypervolemia as significant predictors of readmission.

Conclusions:

  • Approximately 17% of children hospitalized for new-onset lupus nephritis experience readmission within 30 days.
  • Absence of IVMP and the need for albumin-assisted diuresis during initial hospitalization are key risk factors for early readmission in pediatric lupus nephritis.
Abstract

Keywords:
Pediatric lupuspediatric lupus nephritispediatric lupus readmissions

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