Raymond Hakim
Last active: 6/9/2014

Association between repeat hospitalization and early intervention in dialysis patients following hospital discharge.

Chan KE, Lazarus JM, Wingard RL, Hakim RM
Kidney Int. 2009 76 (3): 331-41

PMID: 19516243 · DOI:10.1038/ki.2009.199

Dialysis patients have a greater number of hospitalization events compared to patients without renal failure. Here we studied the relationship between different post-discharge interventions and repeat hospitalization in over 126,000 prevalent hemodialysis patients to explore outpatient strategies that minimize the risk of repeat hospitalization. The primary outcome was repeat hospitalization within 30 days of discharge. Compared to pre-hospitalization values, the levels of hemoglobin, albumin, phosphorus, calcium, and parathyroid hormone and weight were significantly decreased after hospitalization. Using covariate-adjusted models, those patients whose hemoglobin was monitored within the first 7 days after discharge, followed by modification of their erythropoietin dose had a significantly reduced risk for repeat-hospitalization when compared to the patients whose hemoglobin was not checked, nor was the dose of erythropoietin changed. Similarly, administration of vitamin D within the 7 days following discharge was significantly associated with reduced repeat hospitalization when compared to patients on no vitamin D. Therefore, it appears that immediate re-evaluation of anemia management orders and resumption of vitamin D soon after discharge may be an effective way to reduce repeat hospitalization.

MeSH Terms (14)

Aged Anemia Body Weight Erythropoietin Female Hemoglobins Humans Kidney Failure, Chronic Male Middle Aged Patient Readmission Renal Dialysis Retrospective Studies Vitamin D

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