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Hospitalizations of Chronic Dialysis Patients: A National Study in China
Hong Chu1, Chao Yang1,2, Yu Lin3
1Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.
Insights
Hospitalizations among Chinese dialysis patients are frequent, primarily due to access issues. Diabetic kidney disease and peritoneal dialysis increase the risk of multiple annual hospitalizations.
Area of Science:
- Nephrology
- Public Health
- Healthcare Management
Background:
- Chronic dialysis patients have multiple comorbidities and high hospitalization risks.
- This leads to significant healthcare resource utilization.
- Understanding hospitalization patterns in this population is crucial for resource management.
Purpose of the Study:
- To explore the characteristics of hospitalizations among chronic dialysis patients in China.
- To identify risk factors associated with multiple hospitalizations per year.
Main Methods:
- Retrospective analysis of a national inpatient database in China (2013-2015).
- Inclusion of 124,721 chronic dialysis patients with 266,636 hospitalizations.
- Analysis of primary kidney disease, causes of admission, dialysis modality, and comorbidities using multivariable logistic regression.
Main Results:
- The leading causes of hospitalization were dialysis access-related issues (creation and complications).
- Diabetic kidney disease, hypertensive nephropathy, coronary heart disease, cancer, and peritoneal dialysis were identified as risk factors for multiple hospitalizations.
- Approximately 25% of patients experienced more than one hospitalization annually.
Conclusions:
- This study characterizes the significant burden of hospitalizations in China's chronic dialysis population.
- Findings underscore the need for targeted management strategies to reduce hospitalization rates.
- Effective interventions are essential for improving patient outcomes and optimizing healthcare resource allocation.
Background:
Patients receiving chronic dialysis are usually with multiple comorbidities and at high risk for hospitalization, which lead to tremendous health care resource utilization. This study aims to explore the characteristics of hospitalizations among chronic dialysis patients in China.
Methods:
Hospital admissions from January 2013 to December 2015 were extracted from a national inpatient database in China. Chronic dialysis, including hemodialysis and peritoneal dialysis, was identified according to inpatient discharge records and International Classification of Diseases-10 (ICD-10) codes. The primary kidney disease, causes of admissions, modalities of dialysis, and comorbidities were analyzed. Multivariable logistic regression model was used to assess the association of patient characteristics with multiple hospitalizations per year.
Results:
Altogether, 266,636 hospitalizations from 124,721 chronic dialysis patients were included in the study. The mean age was 54.46 ± 15.63 years and 78.29% of them were receiving hemodialysis. The leading cause of hospitalizations was dialysis access-related, including dialysis access creation (25.06%) and complications of access (21.09%). The following causes were nonaccess surgery (1.89%), cardiovascular disease (1.66%), and infectious diseases (1.43%). One-fourth of the patients were hospitalized more than once per year. Multivariate logistic regression models indicated that the primary kidney disease of diabetic kidney disease (odds ratio [OR]: 1.16, 95% confidence interval [CI]: 1.11-1.22) or hypertensive nephropathy (OR: 1.33, 95% CI: 1.27-1.40), coronary heart disease (OR: 1.09, 95% CI: 1.05-1.14), cancer (OR: 1.21, 95% CI: 1.13-1.30), or modality of peritoneal dialysis (OR: 2.67, 95% CI: 2.59-2.75) was risk factors for multiple hospitalizations.
Conclusion:
Our study described characteristics and revealed the burden of hospitalizations of chronic dialysis patients in China. These findings highlight the importance of effective and efficient management strategies to reduce the high burden of hospitalization in dialysis population.
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