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Related Concept Videos

Acute Kidney Injury III: Clinical Manifestations01:29

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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Acute Kidney Injury I: Introduction01:22

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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Chronic Kidney Disease I: Introduction01:25

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Chronic Kidney Disease III: Interprofessional Care01:28

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Related Experiment Video

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Use of Ultra-high Field MRI in Small Rodent Models of Polycystic Kidney Disease for In Vivo Phenotyping and Drug Monitoring
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Unplanned 30-Day Readmission Rates for Autosomal Dominant Polycystic Kidney Disease: Insight from the Nationwide

Aparna Saha1,2,3, Paulette Ericksen4,5, Cristina Liriano Cepin1,2

  • 1The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Blood Purification
|November 1, 2022
PubMed
Summary

Patients with end-stage kidney disease (ESKD) on dialysis and autosomal dominant polycystic kidney disease (ADPKD) have lower 30-day readmission rates but higher healthcare costs. ADPKD patients experienced 31% fewer readmissions and 43% less mortality during readmissions.

Keywords:
Autosomal dominant polycystic kidney diseaseEnd-stage kidney disease on dialysisEpidemiologyNationwide Readmissions DatabaseReadmission rates

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Area of Science:

  • Nephrology
  • Epidemiology
  • Health Services Research

Background:

  • Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder often leading to end-stage kidney disease (ESKD).
  • Limited data exists on 30-day readmission epidemiology and risk factors for ESKD patients with ADPKD in the USA.
  • Understanding readmission patterns is crucial for optimizing care and resource allocation.

Purpose of the Study:

  • To evaluate 30-day unplanned readmission rates among ESKD patients on dialysis with and without ADPKD.
  • To identify predictors of readmission and analyze inpatient care costs in these patient groups.
  • To compare outcomes between ESKD patients with and without ADPKD.

Main Methods:

  • Utilized the Nationwide Readmissions Database (2013-2018) for a nationally representative cohort.
  • Identified ESKD patients on dialysis with and without ADPKD using ICD-9/ICD-10 codes.
  • Analyzed 30-day unplanned readmission rates, reasons, mortality, costs, and adjusted predictors via logistic regression.

Main Results:

  • ADPKD patients (0.58% of cohort) had significantly lower 30-day readmission rates (18.8% vs. 23.8%, p < 0.0001).
  • ADPKD patients were 31% less likely to be readmitted and 43% less likely to die during readmissions.
  • Hospitalization and readmission costs were higher for ADPKD patients, who were also younger and had fewer comorbidities upon readmission.

Conclusions:

  • ESKD patients on dialysis with ADPKD demonstrate lower 30-day readmission rates compared to non-ADPKD counterparts.
  • While ADPKD is associated with reduced inpatient mortality during readmissions, it incurs higher healthcare expenses.
  • Further research into cost-effectiveness and care management strategies for ADPKD patients with ESKD is warranted.