Factors Affecting Readmission in Hospitalized Patients with Chronic Kidney Disease: A Single Center Study

Abstract

Introduction
Chronic Kidney disease (CKD) in itself and the associated comorbidities together put the patients at increased risk of hospitalization. We aimed to study the factors associated with hospital readmission within 30 days of discharge in hospitalized patients with CKD.

Methods
This was a single center descriptive observational study conducted in Tribhuvan University Teaching Hospital (TUTH), Kathmandu. Hospitalized CKD patients were evaluated for sociodemographic parameters, clinical profile and laboratory parameters; they were asked over the phone after 30 days of discharge if they had repeat hospitalization. Readmission rates were calculated and factors at admission associated with repeat hospitalization were analyzed.

Results
Out of 337 CKD patients  307 could be contacted. Fifty patients (16.28%) needed readmission. Readmission rate was higher  in patients older than 75 years and between ages 25 to 50. Patients who were undergoing dialysis at TUTH (OR 3.324 CI 1.239-8.917, p=0.02), who belonged to Newari community (OR  2.85 CI 1.17-6.9, p=0.02) and those from Kathmandu valley (1.94,CI 0.94-3.99) had higher odds of readmission.  Hypertension, diabetes mellitus and tuberculosis as a comorbidity had increased odds of readmission of (1.51,CI 0.60-3.77), (1.48, CI 0.79-2.76), (1.569,CI 0.441-4.468) respectively. Hemoglobin less than 9gm/dl and serum albumin less than 35gm/l had higher odds of readmission of (1.109 95% CI 0.605-2.033) and (1.877,95%CI  0.869-4.054) respectively.

Conclusion
Overall 30 day readmission rate of Hospitalized CKD patients was 16.28%. Elderlies, those with medical comorbiditites, anemic and hypoalbuminemic patients tended to have increased  odds of readmission.