Risk Factors of Rehospitalization in Chronic Kidney Disease Patients: An Observational Study

Objective: The objective of the study was to determine the factors associated with early rehospitalization among patients with chronic kidney disease. Methods: This was a case-control study conducted at the Department of Nephrology, The Kidney Centre, Postgraduate Training Institute, Karachi, Pakistan. Each group (rehospitalization and no rehospitalization) had 63 subjects. The subjects were deemed eligible if they were known cases of chronic kidney disease, above 30 years of age, either gender, cases with rehospitalization within 30 days of discharge from the hospital, and controls with no rehospitalization within 30 days of discharge from the hospital. Odds ratio was calculated to observe the strength of association between factors and rehospitalization. Results: A total of 126 patients were enrolled. The mean age of patients in cases and controls was 69.5 +/- 6.7 and 62.0 +/- 9.6 years, respectively. Diabetes mellitus and heart failure were more common in the cases cohort in comparison with controls (69.8% vs. 34.9% and 50.8% vs. 7.9%, respectively). Among cases, mean serum hemoglobin and albumin levels were statistically lower in contrast to controls (10.0 +/- 0.8 vs. 12.2 +/- 1.0 g/dL, P <.0001 and 3.0 +/- 0.6 versus 3.9 +/- 0.5 mg/dL, respectively, P <.0001). Serum creatinine level was significantly higher in cases than in controls (2.8 +/- 0.4 vs. 1.7 +/- 0.3 mg/dL, respectively, P <.0001). The multivariate association of comorbidities with rehospitalization of chronic kidney disease patients was studied and found significant for diabetes mellitus (OR 7.07, CI 2.73-18.29, P <.0001) and heart failure (odds ratio 18.72, CI 5.72-61.25, P <.0001). Conclusion: The study showed that serum hemoglobin and albumin were significantly lower in rehospitalized cases. Furthermore, diabetes mellitus and heart failure were observed as significant risk factors for early rehospitalization.