ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2021 and some content may be unavailable. To unlock all content for 2021, please visit the archives.

Abstract: PO0803

Risk of 30-Day Hospital Readmission in Patients with ESKD with and Without Autosomal Dominant Polycystic Kidney Disease

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Saha, Aparna, Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
  • Ericksen, Paulette, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Liriano Cepin, Cristina M., Icahn School of Medicine at Mount Sinai Charles Bronfman Institute for Personalized Medicine, New York, New York, United States
  • Coca, Steven G., Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
  • Nadkarni, Girish N., Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
  • Chan, Lili, Icahn School of Medicine at Mount Sinai Department of Medicine, New York, New York, United States
Background

Among end stage kidney disease (ESKD) patients with autosomal dominant polycystic kidney disease (ADPKD), relatively little is known about the epidemiology and risk factors for 30-day readmissions in the US. Therefore, we evaluated the 30-day unplanned readmission rates and predictors, and inpatient care costs among ESKD with and without ADPKD patients using a nationally representative, all-payer database.

Methods

We utilized the Nationwide Readmission Database from 2016-2018 to identify patients admitted for ESKD with and without ADPKD using ICD-10 codes. We used a propensity scoring method assigned to each hospitalization computed by multivariate logistic regression model to establish matched cohorts to reduce bias due to confounding covariates (age, gender, patients’ insurance type, quartile classification of median household income extrapolated from zip code, Elixhauser comorbidity index (ECI), hospital location and teaching status) between the 2 groups. We used survey logistic regression to evaluate the association of ADPKD with 30-day hospital readmission.

Results

From 2016-2018, after propensity matching, there were 11,578 index admissions for ESKD patients with ADPKD and 11,422 index admissions for ESKD patients without ADPKD. Those who had ADPKD during index admissions had fewer 30 days readmissions(12.8% vs 15.3%, p<.0001). The cost of hospitalizations and readmissions in ESKD patients with ADPKD were higher than non-ADPKD patients(Figure 1A). Patients who were readmitted were more likely to have kidney transplant, non-routine discharges, and have non-elective index admissions. Longer length of stay, Medicaid insurance, discharge to short term hospital, specialized care, home health care and against medical advice were associated with increased odds of readmission, and higher ECI score and ADPKD was associated with decreased odds of readmission(aOR 0.85, 95% CI 0.8 – 0.9) (Figure 1B).

Conclusion

ESRD patients with ADPKD were less likely to have 30-day readmission than patients without ADPKD.