Causes of hospital admission of chronic kidney disease patient in a tertiary kidney care hospital
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Abstract
Background: Patients with chronic kidney disease (CKD) are at the risk of increase hospital admission as compared to the general population, due to various reasons. They have increased vulnerability to cardiovascular diseases (CVD) as well as infections, therefore they usually got admit in health care units due to various reasons. The causes of hospitalization in CKD patients in this part of the world are not studied well.
Methods: This cross sectional study was conducted in The Kidney Centre Post Graduate Training Institute (TKC-PGTI) of Karachi. Variables included in the study were age, gender, are of residence, ethnicity, smoking status and level of education. Comorbid conditions like causes of CKD and causes of hospitalization. Data analysis performed by using software IBM SPSS 21.
Results: Total of 269 patients were enrolled in our study. The male 148(55%), mean age was 55 years. The most common cause of hospitalization in our population was infection148 (55%) and urinary tract infection (UTI) was the most common site of infection 55 (20%) followed by sepsis of unknown origin 29(10.8%). Cardiovascular events like volume overload 32 (11.4%) and acute coronary syndrome 20(7.4%) were the second most important cause of hospitalization.
Conclusion: Hospitalization of CKD patients is high, and in our population infection is found to be the leading cause of hospital admission. Infection originating from urinary tract is more common in all stages of CKD patients, while blood born infection originating from double lumen (DL) dialysis catheter or arteriovenous fistula (AVF) cannulation is more common in dialysis population. Cardiovascular events, both acute coronary syndrome and pulmonary edema due to volume overload followed the infections.
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Hill NR, Fatoba ST, Oke JL, Hirst JA, O'Callaghan CA, et al. Global prevalence of chronic kidney disease – A systemic review and Mata-Analysis. Plos On. 2016; 11: e0158765. Ref.: http://bit.ly/2WWdMFc
Culleton BF, Larson MG, Wilson PW, Evans JC, Parfrey PS, et al. Cardiovascular disease and mortality in a community-based cohort with mild renal insufficiency. Kidney int. 1999; 56: 2214-9. Ref.: http://bit.ly/2KtIX9m
Naqvi SB, Collins AJ. Infectious complications in chronic kidney disease. Adv Chronic Kidney Dis. 2006; 13:199-204. Ref.: http://bit.ly/31MPL7b
Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, et al. Chronic kidney disease and mortality risk: A systematic review. J Am Soc Nephrol. 2006; 17: 2034-2047. Ref.: http://bit.ly/2RrFhpf
Kalantar-Zadeh K, Block G, Humphreys MH, Kopple JD. Reverse epidemiology of cardiovascular risk factors in maintenance dialysis patients. Kidney int. 2003; 63: 793-808. Ref.: http://bit.ly/2XnOoN7
Kopple JD. The phenomenon of altered risk factor patterns or reverse epidemiology in persons with advanced chronic kidney failure. Am J Clin Nutr. 2005; 81: 1257-1266. Ref.: http://bit.ly/2WYCGco
Sarnak MJ, Jaber BL. Mortality caused by sepsis in patients with end-stage renal disease compared with the general population. Kidney Int. 2000; 58: 1758-1764. Ref.: http://bit.ly/2RsIntd
Laurin LP, Harrak H, Elftouh N, Ouimet D, Vallée M, et al. Outcomes of infection-related hospitalization according to dialysis modality. Clin J Am Soc Nephrol. 2015: 10; 817-824. Ref.: http://bit.ly/2Rshjdn
Dalrymple LS, Mu Y, Romano PS, Nguyen DV, Chertow GM, et al. Outcomes of infection-related hospitalization in Medicare beneficiaries receiving in-center hemodialysis. Am J Kidney Dis. 2015; 65: 754-762. Ref.: http://bit.ly/2Zz25pV
Ishani A, Collins AJ, Herzog CA, Foley RN. Septicemia, access and cardiovascular disease in dialysis patients: the USRDS Wave 2 study. Kidney Int. 2005; 68: 311-318. Ref.: http://bit.ly/2N3oAlv
Dalrymple LS, Katz R, Kestenbaum B, de Boer IH, Fried L, et al. The risk of infection-related hospitalization with decreased kidney function. Am J Kidney Dis. 2012; 59: 356-363. Ref.: http://bit.ly/2IYACr3
Vinogradova Y, Hippisley-Cox J, Coupland C. Identification of new risk factors for pneumonia: population-based case-control study. Br J Gen Pract. 2009; 59: 329-338. Ref.: http://bit.ly/2N0fnu8
Saran R, Robinson B, Abbott KC, Agodoa LY, Albertus P, et al. US Renal Data System 2016 Annual Data Report: epidemiology of kidney disease in the United States. Am J Kidney Dis. 2017; 69: 7-8. Ref.: http://bit.ly/2XoKljr
Deen J, von Seidlein L, Andersen F, Elle N, White NJ, et al. Community-acquired bacterial bloodstream infections in developing countries in south and southeast Asia: a systematic review. Lancet Infect Dis. 2012; 12: 480-487. Ref.: http://bit.ly/2ZGelF7
Viasus D, Garcia-Vidal C, Cruzado JM, Adamuz J, Verdaguer R, et al. Epidemiology, clinical features and outcomes of pneumonia in patients with chronic kidney disease. Nephrology Dialysis Transplantation. 2011; 26: 2899-2906. Ref.: http://bit.ly/2Ku0duS
Chou CY, Wang SM, Liang CC, Chang CT, Liu JH, et al. Risk of Pneumonia Among Patients With Chronic Kidney Disease in Outpatient and Inpatient Settings: A Nationwide Population-Based Study. Medicine. 2014; 93: 1-4. Ref.: http://bit.ly/2L5COj9
Di Napoli A, Pezzotti P, Di Lallo D, Tancioni V, Papini P, et al. Determinants of hospitalization in a cohort of chronic dialysis patients in central Italy. J Nephrol. 2005; 18: 21-29. Ref.: http://bit.ly/2Xv15FK
Weinhandl ED, Nieman KM, Gilbertson DT, Collins AJ. Hospitalization in daily home hemodialysis and matched thrice-weekly in-center hemodialysis patients. Am J Kidney Dis. 2015; 65: 98-108. Ref.: http://bit.ly/2WVlQq2
Rocco MV, Soucie JM, Reboussin DM, McClellan WM. Risk factors for hospital utilization in chronic dialysis patients. Southeastern Kidney Council (Network 6). J Am Soc Nephrol. 1996; 7: 889-896. Ref.: http://bit.ly/2XoucdX
Holland DC, Lam M. Predictors of hospitalization and death among predialysis patients: a retrospective cohort study. Nephrol Dial Transplant. 2000; 15: 650-658. Ref.: http://bit.ly/2XsKGSi