Related Experiment Video
Updated: Jul 1, 2025
10:37
Comparative Proteomic Analysis of Whole Kidney, Medulla, and Cortical Tubules in Diabetic Pathogenesis of Kidney Injury in Mice
Published on: May 2, 2025
149
Hospital Readmissions for Fluid Overload among Individuals with Diabetes and Diabetic Kidney Disease: Risk Factors
Jiashen Cai1,2, Dorothy Huang1, Hanis Binte Abdul Kadir3
1Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
Nephron
|March 6, 2024
Summary
Hospital readmissions for fluid overload in diabetes and diabetic kidney disease patients can be reduced. New risk models identify high-risk individuals, enabling targeted interventions to prevent hospitalizations.
Area of Science:
- Nephrology
- Endocrinology
- Cardiology
Background:
- Hospital readmissions for fluid overload are a significant concern for patients with diabetes and diabetic kidney disease.
- Recurrent fluid overload can be mitigated through evidence-based interventions.
Purpose of the Study:
- To develop and validate risk prediction models for fluid overload readmissions in patients with diabetes and diabetic kidney disease.
- To identify patients who would benefit from targeted interventions to reduce hospitalizations.
Main Methods:
- A single-center retrospective cohort study included 1,531 adult patients with diabetes and diabetic kidney disease hospitalized for fluid overload.
- Multivariable regression models were developed and compared against the LACE score for 30-day and 90-day readmissions.
Main Results:
- History of alcoholism and prior fluid overload hospitalizations were associated with 30-day readmissions.
- Cardiovascular disease and lower eGFR were linked to 90-day readmissions in diabetic kidney disease patients.
- Developed models demonstrated superior discrimination and calibration compared to the LACE score, with significant Net Reclassification Index (NRI) improvements.
Conclusions:
- Risk prediction models can effectively identify patients at high risk for fluid overload readmission.
- These models support the implementation of targeted interventions to reduce preventable hospitalizations.
- Further research can refine these models for broader clinical application.
Related Concept Videos
01:22Heart Failure Drugs: Diuretics
375
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
375
01:17Factors Affecting Renal Clearance: Renal Impairment
91
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
91
01:29Disorder of Water Balance
391
Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
Dehydration
Dehydration occurs when the body loses fluids (particularly water).
Causes:
The major causes of dehydration include excessive sweating, fever, vomiting, diarrhea, and diuresis.
Signs and Symptoms:
Symptoms primarily include intense...
391
01:18Fluid Movement Between Compartments
516
The force applied by fluids against a surface, known as hydrostatic pressure, initiates the transfer of fluid among different compartments. Within our blood vessels, the blood's hydrostatic pressure is a result of the heart's pumping action. At the arteriolar end of capillaries, hydrostatic pressure (capillary blood pressure) exceeds the opposing colloid osmotic pressure created primarily by plasma proteins like albumin. This discrepancy in pressure propels plasma and nutrients from the...
516
01:11Renal Failure: Dose Adjustments
88
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
88
01:25Regulation of Water Intake
500
Osmolality refers to the number of solute particles per kilogram of solvent in a solution. Plasma osmolality specifically indicates the total number of solute particles per kilogram of water in blood plasma. This value reflects the body's hydration status and is tightly regulated through mechanisms controlling water intake and output. While water consumption is a conscious decision, the body has intrinsic regulatory systems to maintain fluid balance. Dehydration, a state of water deficit...
500