Abstract: FR-PO0665
Nephrotic Syndrome Outcomes in Teaching Hospitals: NIS 2017-2018
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - ANCA/FSGS
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Ali, Ahmad, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
- Zafar, Muhammad Usman, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
- Zaidi, Syed Haris Mustafa, Lehigh Valley Health Network, Allentown, Pennsylvania, United States
Background
Nephrotic syndrome (NS) is associated with significant inpatient morbidity and healthcare utilization. Common etiologies include minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy and diabetic nephropathy. Teaching hospitals often manage patients with greater clinical complexity and comorbidity burden; however, the impact of teaching hospital status on outcomes in hospitalized NS patients remain unclear. We evaluated the association between hospital teaching status and inpatient outcomes among adults hospitalized with NS.
Methods
This is a retrospective study using the 2017–2018 National Inpatient Sample. Adult hospitalizations with any diagnosis of NS were identified using ICD-10-CM codes and stratified by teaching versus non-teaching hospital status. Outcomes assessed included inpatient mortality, hospital length of stay (LOS) and total hospitalization cost. Multivariable logistic and linear regression analyses were performed adjusting for comorbidities.
Results
A total of 8,429 patients with NS were identified, representing 42,144 weighted national hospitalizations; 77% were admitted to teaching hospitals. Mean age was higher in teaching hospitals (56.7 vs. 53.7 years). Crude inpatient mortality was lower in teaching hospitals (2.47% vs. 2.87%); however, teaching hospital status was not independently associated with mortality after adjustment (OR 0.87, 95% CI 0.59–1.29; p=0.488). Independent predictors of increased mortality included acute kidney injury (AKI), sepsis, shock, congestive heart failure, stroke, metastatic cancer, older age, and female sex. Teaching hospital admission was independently associated with longer LOS (8 days vs 6.8 days, 95% CI 0.82–1.52; p<0.001) and higher cost (82,724$ vs 68512$, 95% CI 6,299–18,235; p<0.001). AKI, sepsis, shock, stroke, venous thromboembolism, and congestive heart failure were major contributors to prolonged LOS and increased cost.
Conclusion
Among hospitalized patients with NS, teaching hospitals admission was associated with longer LOS and higher cost without a difference in mortatity. This may reflect referral of more clinically complex patients and greater use of multidisciplinary care and advanced diagnostics at tertiary centers. Comorbid conditions such as AKI, sepsis, and cardiovascular disease were the main drivers of adverse outcomes. Further studies are needed to clarify mechanisms underlying these worse outcomes.