Kidney Week

Abstract: FR-PO930

Hospitalization Lengths of Stay Among a National Cohort of Advanced CKD Patients Treated With Conservative Management vs. Dialysis

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

• You, Amy Seung, University of California Irvine, Irvine, California, United States

Amy Seung You,

• Kalantar-Zadeh, Kamyar, University of California Irvine, Irvine, California, United States

Kamyar Kalantar-Zadeh,

• Narasaki, Yoko, University of California Irvine, Irvine, California, United States

Yoko Narasaki,

• Mukamel, Dana B., University of California Irvine, Irvine, California, United States

Dana B. Mukamel,

• Crowley, Susan T., Yale University, New Haven, Connecticut, United States

Susan T. Crowley,

• Yoon, Ji Hoon, University of California Irvine, Irvine, California, United States

Ji Hoon Yoon,

• Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States

Csaba P. Kovesdy,

• Nguyen, Danh V., University of California Irvine, Irvine, California, United States

Danh V. Nguyen,

• Rhee, Connie, University of California Irvine, Irvine, California, United States

Connie Rhee,

Background

While dialysis has been the prevailing treatment paradigm in advanced CKD patients progressing to ESKD, this approach may lead to loss of independence/function and greater healthcare utilization in certain groups. We compared the impact of dialysis vs. conservative management (CM) on hospitalization lengths of stay (LOS) in advanced CKD.

Methods

We examined a national cohort of advanced CKD patients treated with CM vs. dialysis over 1/07-6/20 from the Optum Labs Data Warehouse, which contains de-identified administrative claims, including medical and pharmacy claims and enrollment records for commercial and Medicare Advantage enrollees as well as EHR data. In primary analyses, patients were categorized according to receipt of CM, defined as not receiving dialysis within 2-yrs of the index eGFR (1^st eGFR<25), vs. dialysis. We compared LOS among patients treated with CM vs. dialysis hospitalized within 2-yrs of their index eGFR using linear mixed effects models that separately considered fixed age of the cohort (65-years), with varying time of hospitalization from the index eGFR, as well as a fixed time of hospitalization from the index eGFR (12 months) with varying age.

Results

Among 169,479 advanced CKD patients who were hospitalized within 2-yrs of the index eGFR, there were a total of 620,168 hospitalizations over this period. In analyses considering fixed age, dialysis patients had longer average LOS vs. CM patients, with differences attenuating over time (Fig A). In analyses considering fixed time of hospitalization from the index eGFR, dialysis patients >20-yrs had longer average LOS vs. CM patients, with differences increasing with older age (Fig B).

Conclusion

Compared to dialysis, CM patients had shorter LOS across varying time points and ages. Further studies are needed to examine the comparative effectiveness of CM vs. dialysis transition on CKD outcomes.

Funding

• NIDDK Support