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Recurrent Hospitalizations for Fluid Overload in Diabetes with Kidney Failure Treated with Dialysis
Chee Chin Phang1,2,3, Li Choo Ng1,4, Hanis Abdul Kadir5
1Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore.
Cardiorenal Medicine
|November 7, 2024
Summary
Fluid overload readmissions are common in diabetic patients with end-stage kidney disease (ESKD). Key risk factors include heart disease and low hemoglobin, guiding interventions to reduce hospitalizations.
Area of Science:
- Nephrology
- Cardiology
- Endocrinology
Background:
- Diabetes mellitus is a leading cause of end-stage kidney disease (ESKD).
- ESKD patients face significant burdens, including high rates of fluid overload hospitalizations.
- Identifying risk factors for fluid overload readmissions is crucial for patient management.
Purpose of the Study:
- To characterize risk factors for fluid overload readmissions in diabetic ESKD patients.
- To identify high-risk hospitalizations for targeted interventions.
- To reduce recurrent fluid overload hospitalizations.
Main Methods:
- Retrospective cohort study of adult diabetic ESKD patients on dialysis.
- Analysis of hospitalizations for fluid overload (2018-2021).
- Multivariable Cox regression for 30- and 90-day readmissions.
Main Results:
- 18.1% and 29.9% of fluid overload hospitalizations had 30- and 90-day readmissions, respectively.
- Ischemic heart disease, peripheral vascular disease, and low hemoglobin were associated with readmissions.
- Heart failure, hemodialysis, and lack of statin use increased 90-day readmission risk.
Conclusions:
- Modifiable factors (hemoglobin, statin use) and non-modifiable factors (heart disease) impact readmission risk.
- Results support risk stratification for targeted interventions.
- Interventions can reduce avoidable readmissions for fluid overload in diabetic ESKD.
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