Hospitalizations Among Adults With CKD in Public Renal Specialty Practices: A Retrospective Study From Queensland, Australia

Vishal  Diwan; Wendy E.  Hoy; Zaimin  Wang; Jianzhen  Zhang; Anne  Cameron; Sree K.  Venuthurupalli; Robert G.  Fassett; Samuel  Chan; Helen G Healy; Ken-Soon  Tan; Richard  Baer; Andrew J.  Mallett; Nicholas Gray; Murty  Mantha; Roy  Cherian; Clyson  Mutatiri; Krishan  Madhan; George  Kan; Danielle  Wu; Geoffrey K Mitchell; Thin  Han; Adrian  Kark; Shahadat  Hossain; Thomas  Titus; Dwarakanatan  Ranganathan; Ann  Bonner; Sridevi  Govindarajulu

doi:10.1016/j.xkme.2023.100700

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Hospitalizations Among Adults With CKD in Public Renal Specialty Practices: A Retrospective Study From Queensland, Australia

Journal article

Open access

Peer reviewed

Hospitalizations Among Adults With CKD in Public Renal Specialty Practices: A Retrospective Study From Queensland, Australia

Vishal Diwan, Wendy E. Hoy, Zaimin Wang, Jianzhen Zhang, Anne Cameron, Sree K. Venuthurupalli, Robert G. Fassett, Samuel Chan, Helen G Healy, Ken-Soon Tan, …

Kidney Medicine, Vol.5(9), pp.1-12

2023

DOI: https://doi.org/10.1016/j.xkme.2023.100700

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Abstract

Chronic kidney disease (CKD)

epidemiology

hospital admissions

readmissions

emergency admissions

kidney replacement therapy (KRT)

Rationale & Objective: Little is known about hospital admissions in non-dialysis chronic kidney disease (CKD) patients before death or starting kidney replacement therapy (KRT). Study Design: Retrospective observational cohort study Setting & Participants: Hospitalisations among 7,201 CKD patients from 10 public renal clinics in Queensland, enrolled in the CKD.QLD registry starting in May 2011, were followed for 25,496.34 person-years until they started KRT or died, or until June 30, 2018. Predictors: Demographic and clinical characteristics of CKD patients Outcomes: Hospital admissions Analytical Approach: We evaluated the association of demographic and clinical features with hospitalisations, length of stay and cost. Results: 81.5% of patients were admitted at least once, with 42,283 admissions, costing AUD 231 million. The average number of admissions per person year were 1.7, and the cost was AUD 9,060, 10 times and 2 times their Australian averages, respectively. Single (1-day) admissions constituted 59.2% of all hospital episodes, led by neoplasms (largely chemotherapy), anaemia, CKD-related and eye conditions (largely cataract extractions), but only 14.8% of total costs. ∼41% of admissions were >1-day admissions, constituting 85.2% of total costs, with cardiovascular conditions, respiratory conditions, CKD-related and Injuries/fractures/poisoning the dominant causes. Readmissions within 30 days of discharge constituted more than 42% of admissions and 46.8% costs. Admissions not directly related to CKD constituted 90% of admissions and costs. More than 40% of admissions and costs were through the emergency department. Almost 19% of hospitalised patients and 27% of admissions did not have kidney disease mentioned as either principal or associate causes. Limitations: Variable follow-up times because of different dates of consent. Conclusions: The hospital burden of CKD patients is mainly driven by complex multi-day admissions and readmissions involving comorbidities which may not be directly related to their CKD. Strategies to prevent these complex admissions and readmissions should minimise hospital costs and outcomes.

Details

Title: Hospitalizations Among Adults With CKD in Public Renal Specialty Practices: A Retrospective Study From Queensland, Australia
Authors: Vishal Diwan (Author) - The University of Queensland
Wendy E. Hoy (Corresponding Author) - The University of Queensland
Zaimin Wang (Author) - The University of Queensland
Jianzhen Zhang (Author) - The University of Queensland
Anne Cameron (Author) - The University of Queensland
Sree K. Venuthurupalli (Author) - The University of Queensland
Robert G. Fassett (Author) - The University of Queensland
Samuel Chan (Author) - The University of Queensland
Helen G Healy (Author) - The University of Queensland
Ken-Soon Tan (Author) - Logan Hospital
Richard Baer (Author) - Logan Hospital
Andrew J. Mallett (Author) - The University of Queensland
Nicholas Gray (Author) - Sunshine Coast University Hospital
Murty Mantha (Author) - Cairns Private Hospital (Australia)
Roy Cherian (Author) - Nephrology Service (Mackay, Queensland)
Clyson Mutatiri (Author) - Wide Bay Hospital and Health Service (Australia)
Krishan Madhan (Author) - Hervey Bay Hospital (Australia)
George Kan (Author) - Townsville Hospital
Danielle Wu (Author) - Mackay Base Hospital
Geoffrey K Mitchell (Author) - The University of Queensland
Thin Han (Author)
Adrian Kark (Author) - Metro North Health (Australia)
Shahadat Hossain (Author)
Thomas Titus (Author) - Gold Coast Hospital
Dwarakanatan Ranganathan (Author) - Metro North Health (Australia)
Ann Bonner (Author) - Metro North Health (Australia)
Sridevi Govindarajulu (Author) - St Andrew’s Hospital
Publication details: Kidney Medicine, Vol.5(9), pp.1-12
Publisher: Elsevier BV
Date published: 2023
DOI: 10.1016/j.xkme.2023.100700
ISSN: 2590-0595
Copyright note: This is an open access article distributed under the terms of the Creative Commons CC-BY license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Grant note: NHMRC Chronic Kidney Disease Centre of Research Excellence / NHMRC CKD.CRE CKD.QLD
Organisation Unit: UniSC Clinical Trials Centre; University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99741790202621
Output Type: Journal article

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