Risk of Hospitalization for Chronic Hemodialysis Patients

Jones, Katherine R.

doi:10.1111/j.1547-5069.1992.tb00230.x

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…As in other studies [13][14][15], lower albumin levels were a strong risk factor for hospitalization. Ischemic heart disease and vascular disease also were associated with increased risk for hospitalization.…”

Section: Discussionsupporting

confidence: 53%

“…One possible explanation for this is that socioeconomic factors co-segregated with diabetes in our study group. Jones demonstrated that socioeconomic factors, e.g., household size, were risk factors for hospitalization in dialysis patients [14]. Practice patterns that included lower threshold for hospitalizing diabetic HD patients also may have contributed to this finding.…”

Section: Discussionmentioning

confidence: 90%

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Risk Factors for Hospitalization in Well-Dialyzed Chronic Hemodialysis Patients

et al. 1999

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Background/Aims: Hemodialysis (HD) patients are hospitalized more frequently than patients with other chronic diseases, averaging 11.5 hospital days/patient/year. Hospital costs attributable to renal failure in the US exceed $2 billion per year. The present healthcare climate continues to force dialysis providers to focus on these issues in order to optimize patient care while limiting cost. Methods: We used a novel method for analyzing hospitalization risk, a multiple-event Cox proportional hazards model, to identify factors that influenced hospitalization in a HD unit population over a two-year period. This model allows individual patients to contribute multiple failure events to the model while controlling for the serial dependency of events. Results: 178 HD patients were retrospectively examined. There were 381 hospitalizations during the study period, averaging out to 1.9 hospitalizations and 10.5 hospital days/patient-year. Substance abuse and diabetes conveyed the largest risks for hospitalization (diabetes RR: 2.09; substance abuse RR: 2.24) in the study cohort, exposing the necessity for examining practice patterns and behavioral interventions as means for improving HD patient care. Conclusion: Despite the small numbers of patients in this single-center HD population, the model achieved adequate statistical power. Therefore, it has the potential to serve as a continuous quality improvement (CQI) tool in particular HD patient sub-groups, or in individual HD units.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 90%

Risk Factors for Hospitalization in Well-Dialyzed Chronic Hemodialysis Patients

et al. 1999

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“…Dialysis access, cardiovascular diseases and diabetes were the leading causes of increased LOS. In addition to arthritis, low functional ability, hepatitis, smoking, and insurance‐related organizational issues also increased the LOS. Controlling these factors was beyond the scope of this study, leading to difficulty in drawing a cause and effect line between the NEMO study and the LOS.…”

Section: Discussionmentioning

confidence: 99%

Nutritional education for management of osteodystrophy: Impact on serum phosphorus, quality of life, and malnutrition

Karavetian

Elzein²,

Rizk

et al. 2016

Hemodialysis International

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Introduction Osteodystrophy management includes dietary phosphorus restriction, which may limit protein intake, exacerbate malnutrition-inflammation syndrome and mortality among hemodialysis patients. Methods A multicenter randomized controlled trial was conducted in Lebanon, to test the hypothesis that intensive nutrition education focused on phosphorus-to-protein balance will improve patient outcomes. Six hemodialysis units were randomly assigned to the trained hospital dietitian (THD) protocol (210 patients). Six others (184 patients) were divided equally according to the patients' dialysis shifts and assigned to Dedicated Dietitian (DD) and Control protocols. Patients in the THD group received nutrition education from hospital dietitians who were trained by the study team on renal dietetics, but had limited time for hemodialysis patients. Patients in the DD group received individualized nutritional education on dietary phosphorus and protein management for 6 months (2-hour/patient/month) from study renal dietitians. Patients in the control group continued receiving routine care from hospital dietitians who had limited time for these patients and were blinded to the study. Serum phosphorus (mmol/L), malnutrition-inflammation score (MIS), health-related quality of life (HRQOL) index and length of hospital stay (LOS) were assessed at T0 (baseline), T1 (postintervention) and T2 (post6 month follow up). Findings Only the DD protocol significantly improved serum phosphorus (T0:1.78 ± 0.5, T1:1.63 ± 0.46, T2:1.69 ± 0.53), 3 domains of the HRQOL and maintained MIS at T1, but this protective effect resolved at T2. The LOS significantly dropped for all groups. Discussion The presence of competent renal dietitians fully dedicated to hemodialysis units was superior over the other protocols in temporarily improving patient outcomes.

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“…Table 1 shows all of the KPS categories. KPS has been in use for half a century and has been applied to many ESRD populations [23][24][25][26], and therefore allows wide comparison. However, it has several limitations.…”

Section: Functioningmentioning

confidence: 99%

Health Related Quality of Life in Patients with Chronic Kidney Disease

2005

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Monitoring a patient's functional status and the subjective state of well being as it related to health condition, together known as health related quality of life (HRQOL) measurements, is of particular importance in patients with chronic kidney disease (CKD) including those with end stage renal disease (ESRD). The concept of quality of life in dialysis has evolved since the inception of renal replacement therapy from simple survival to enjoying a certain level of well being. The measurement of dialysis outcomes have paralleled the improvement in the delivery of renal replacement therapy progressing from level of functioning, symptom checklists, multi dimensional well being, and moving perhaps to more patient centered quality of life. HRQOL domains have been strongly associated with objective patient outcomes. The self reported physical functioning and mental well being correlate with serum albumin and body composition measures. The ability of those on hemodialysis to self administer questionnaires is a barrier to the widespread use of multidimensional HRQOL assessment in clinical practice. However, new technologies using computer adaptive testing and item response theory may allow those questionnaires to be quickly and more efficiently administered by clinic staff. The finding of different HRQOL scores among CKD patients of different racial and ethnic backgrounds supports the need to individualize the concept of HRQOL, so that we can assess the crucial aspects of life in our patients and integrate these domains into a comprehensive plan of care. These recent findings underline the critical need to measure HRQOL and to expand the boundaries of our multidimensional tools with technology and a more patient centered concept of quality of life.

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Risk of Hospitalization for Chronic Hemodialysis Patients

Cited by 7 publications

References 28 publications

Risk Factors for Hospitalization in Well-Dialyzed Chronic Hemodialysis Patients

Risk Factors for Hospitalization in Well-Dialyzed Chronic Hemodialysis Patients

Nutritional education for management of osteodystrophy: Impact on serum phosphorus, quality of life, and malnutrition

Health Related Quality of Life in Patients with Chronic Kidney Disease

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