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Risk of Hospital Readmission among People with CKD: A Population-Based Cohort Study
Badal S B Pattar1,2, Emir Sevinc1, Tayler D Scory1
1Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
Summary
People with chronic kidney disease (CKD) face high risks of readmission and death, especially with lower estimated glomerular filtration rate (eGFR). Congestive heart failure is a common cause, highlighting the need for targeted discharge plans for CKD patients.
Area of Science:
- Nephrology
- Public Health
- Geriatrics
Background:
- Individuals with chronic kidney disease (CKD) exhibit elevated risks of recurrent hospitalization and mortality compared to the general population.
- Investigating readmission risks across CKD categories can inform targeted interventions and improve discharge planning for potentially avoidable readmissions.
Purpose of the Study:
- To assess the association between estimated glomerular filtration rate (eGFR) and 30-day unplanned hospital readmission or death in CKD patients.
- To identify common diagnoses contributing to readmissions among CKD patients.
Main Methods:
- A retrospective cohort study included 2,992,810 admissions from 1,249,248 adults discharged from Alberta, Canada hospitals (2005-2021).
- Preadmission eGFR was categorized into eight groups. The primary outcome was unplanned readmission or death within 30 days.
- Multivariable logistic regression was used to estimate odds ratios, with stratification by age and sex.
Main Results:
- Lower eGFR categories were significantly associated with higher odds of 30-day unplanned readmission or death compared to eGFR ≥60 ml/min per 1.73 m2.
- The highest adjusted odds were observed in kidney transplant recipients (aOR, 1.47) and those with eGFR <15 not on dialysis (aOR, 1.40).
- Heart failure was the most frequent readmission diagnosis in lower eGFR groups, followed by acute kidney injury (AKI).
Conclusions:
- Severe CKD is linked to the highest risk of hospital readmission.
- Interventions targeting volume and hemodynamic issues, such as postdischarge AKI and heart failure, are crucial for high-risk CKD populations.
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