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Kidney Week

Abstract: PO1233

Predictors of 30-Day Hospital Readmission Among Minority ESRD Patients Receiving Maintenance Hemodialysis

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Rungkitwattanakul, Dhakrit "Jesse", Howard University College of Pharmacy, Washington, District of Columbia, United States
  • Ohanele, Chiemena, Howard University College of Pharmacy, Washington, District of Columbia, United States
  • Emezienna, Nkiruka, Howard University College of Pharmacy, Washington, District of Columbia, United States
  • Maneno, Mary K., Howard University College of Pharmacy, Washington, District of Columbia, United States
  • Daftary, Monika N., Howard University College of Pharmacy, Washington, District of Columbia, United States
Background

End-stage renal disease (ESRD) is one of the most prominent disparities as racial/ethnic minorities are 1.5-4 times more likely than others to develop ESRD. Among patients with ESRD receiving hemodialysis, more than 1/3 of hospital discharges are followed by a readmission within 30 days. These subsequent readmissions are associated with increased healthcare costs and poor health outcomes. Therefore, knowing the incidence and risk factors for readmission are crucial steps needed for necessary prevention. This retrospective study aims to identify predictors within inpatient and outpatient care that contribute to 30-day hospital readmissions among minority ESRD patients receiving maintenance hemodialysis within an outpatient dialysis center located in the District of Columbia.

Methods

Data from electronic medical records were taken for patients who have had an unplanned hospital admission between January 1, 2017 and August 31, 2019. Descriptive statistical analysis was conducted for all study variables. Univariate and multivariable logistic regression analyses with 30-day readmission as the dependent outcome were conducted to identify and assess predictors of 30-day readmissions.

Results

A total of 96 patients were included in the study. Among these patients, 49 (51%) had 30-day hospital readmission. Overall, patients were predominantly African American (86.5%), age between the age of 60-69 (29.2%), and with a diagnosis of hypertension (89.6%). A diagnosis of secondary hyperparathyroidism, serum calcium < 8.5mg/dL at time of discharge, and serum PTH < 150pg/mL at time of discharge were significantly associated with higher readmission rates in multivariable analyses (p< 0.05). Gender, race, a weekend discharge, and serum phosphate at time of discharge were not associated with 30-day readmission.

Conclusion

Overall, the study findings provide some insight into risk factors associated with 30-day readmissions in minority patients receiving maintenance hemodialysis. These findings suggest that secondary hyperparathyroidism and chronic kidney disease mineral bone disorder (CKD-MBD) markers predict readmissions. Identifying inpatient and outpatient strategies to mitigate risks and prevent readmissions may improve outcomes among this high-risk ESRD population.