Jianbo Li1,2, Jing Yu1,2, Naya Huang1,2, Hongjian Ye1,2, Dan Wang1,2, Yuan Peng1,2, Xiaobo Guo3, Chunyan Yi1,2, Xiao Yang1,2, Xueqing Yu4,5,6,7. 1. Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China. 2. Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, 510080, Guangdong, China. 3. Department of Statistical Science, School of Mathematics, Sun Yat-sen University, Guangzhou, 510275, Guangdong, China. 4. Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, Guangdong, China. yuxq@mail.sysu.edu.cn. 5. Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, 510080, Guangdong, China. yuxq@mail.sysu.edu.cn. 6. Guangdong Provincial People's Hospital, Guangzhou, 510080, Guangdong, China. yuxq@mail.sysu.edu.cn. 7. School of Medicine, South China University of Technology, Guangzhou, 510080, Guangdong, China. yuxq@mail.sysu.edu.cn.
Abstract
BACKGROUND: Rehospitalization is a major problem for end stage renal disease (ESRD) populations. However, researches on 30-day unexpected rehospitalzation of incident peritoneal dialysis (PD) patients were limited. This study aimed to investigate the prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident PD patients. METHODS: This was a retrospective cohort study. Patients who accepted PD catheter implantation in our centre from Jan 1, 2006 to Dec 31, 2013 and regular follow-up were included. The demographic characteristics, laboratory parameters, and rehospitalization data were collected and analyzed. The primary outcome was all-cause mortality, and the secondary outcomes included cardiovascular disease (CVD) mortality and technical failure. RESULTS: Totally 1632 patients (46.9 ± 15.3 years old, 60.1% male, 25.6% with diabetes) were included. Among them, 149 (9.1%) had a 30-day unexpected rehospitalization after discharge. PD-related peritonitis (n = 48, 32.2%), catheter malfunction (n = 30, 20.1%) and severe fluid overload (n = 19, 12.8%) were the top three causes for the rehospitalization. Multivariate logistic regression analysis showed that length of index hospital stays [Odds ratio (OR) =1.02, 95% confidence interval (CI) 1.00-1.03, P = 0.036) and hyponatremia (OR = 1.85, 95% CI 1.06-3.24, P = 0.031) were independently associated with the rehospitalization. Multivariate Cox regression analysis indicated that 30-day rehospitalization was an independent risk factor for all-cause mortality [Hazard ratio (HR) =1.52, 95% CI 1.07-2.16, P = 0.019) and CVD mortality (HR = 1.73, 95% CI 1.03-2.90, P = 0.038). CONCLUSIONS: The prevalence of 30-day unexpected rehospitalization for incident PD patients in our centre was 9.1%. The top three causes for the rehospitalization were PD-related peritonitis, catheter malfunction and severe fluid overload. Thirty-day unexpected rehospitalization increased the risk of all-cause mortality and CVD mortality for PD patients.
BACKGROUND: Rehospitalization is a major problem for end stage renal disease (ESRD) populations. However, researches on 30-day unexpected rehospitalzation of incident peritoneal dialysis (PD) patients were limited. This study aimed to investigate the prevalence, risk factors and impact on outcomes of 30-day unexpected rehospitalization in incident PD patients. METHODS: This was a retrospective cohort study. Patients who accepted PD catheter implantation in our centre from Jan 1, 2006 to Dec 31, 2013 and regular follow-up were included. The demographic characteristics, laboratory parameters, and rehospitalization data were collected and analyzed. The primary outcome was all-cause mortality, and the secondary outcomes included cardiovascular disease (CVD) mortality and technical failure. RESULTS: Totally 1632 patients (46.9 ± 15.3 years old, 60.1% male, 25.6% with diabetes) were included. Among them, 149 (9.1%) had a 30-day unexpected rehospitalization after discharge. PD-related peritonitis (n = 48, 32.2%), catheter malfunction (n = 30, 20.1%) and severe fluid overload (n = 19, 12.8%) were the top three causes for the rehospitalization. Multivariate logistic regression analysis showed that length of index hospital stays [Odds ratio (OR) =1.02, 95% confidence interval (CI) 1.00-1.03, P = 0.036) and hyponatremia (OR = 1.85, 95% CI 1.06-3.24, P = 0.031) were independently associated with the rehospitalization. Multivariate Cox regression analysis indicated that 30-day rehospitalization was an independent risk factor for all-cause mortality [Hazard ratio (HR) =1.52, 95% CI 1.07-2.16, P = 0.019) and CVD mortality (HR = 1.73, 95% CI 1.03-2.90, P = 0.038). CONCLUSIONS: The prevalence of 30-day unexpected rehospitalization for incident PD patients in our centre was 9.1%. The top three causes for the rehospitalization were PD-related peritonitis, catheter malfunction and severe fluid overload. Thirty-day unexpected rehospitalization increased the risk of all-cause mortality and CVD mortality for PD patients.
Authors: Rajiv Saran; Bruce Robinson; Kevin C Abbott; Lawrence Y C Agodoa; Jennifer Bragg-Gresham; Rajesh Balkrishnan; Nicole Bhave; Xue Dietrich; Zhechen Ding; Paul W Eggers; Abduzhappar Gaipov; Daniel Gillen; Debbie Gipson; Haoyu Gu; Paula Guro; Diana Haggerty; Yun Han; Kevin He; William Herman; Michael Heung; Richard A Hirth; Jui-Ting Hsiung; David Hutton; Aya Inoue; Steven J Jacobsen; Yan Jin; Kamyar Kalantar-Zadeh; Alissa Kapke; Carola-Ellen Kleine; Csaba P Kovesdy; William Krueter; Vivian Kurtz; Yiting Li; Sai Liu; Maria V Marroquin; Keith McCullough; Miklos Z Molnar; Zubin Modi; Maria Montez-Rath; Hamid Moradi; Hal Morgenstern; Purna Mukhopadhyay; Brahmajee Nallamothu; Danh V Nguyen; Keith C Norris; Ann M O'Hare; Yoshitsugu Obi; Christina Park; Jeffrey Pearson; Ronald Pisoni; Praveen K Potukuchi; Kaitlyn Repeck; Connie M Rhee; Douglas E Schaubel; Jillian Schrager; David T Selewski; Ruth Shamraj; Sally F Shaw; Jiaxiao M Shi; Monica Shieu; John J Sim; Melissa Soohoo; Diane Steffick; Elani Streja; Keiichi Sumida; Manjula Kurella Tamura; Anca Tilea; Megan Turf; Dongyu Wang; Wenjing Weng; Kenneth J Woodside; April Wyncott; Jie Xiang; Xin Xin; Maggie Yin; Amy S You; Xiaosong Zhang; Hui Zhou; Vahakn Shahinian Journal: Am J Kidney Dis Date: 2019-02-21 Impact factor: 8.860
Authors: Lili Chan; Kinsuk Chauhan; Priti Poojary; Aparna Saha; Elizabeth Hammer; Joseph A Vassalotti; Lindsay Jubelt; Bart Ferket; Steven G Coca; Girish N Nadkarni Journal: Clin J Am Soc Nephrol Date: 2017-09-28 Impact factor: 8.237