| Title |
Hospital readmission in children on maintenance dialysis: a multicentre, prospective cohort study |
| Authors |
Özdemir Atikel, Yeşim ; Lévai, Eszter ; Schmitt, Claus Peter ; Adalat, Shazia ; Goodman, Nadine ; Pınarbaşı, Ayşe Seda ; Dursun, İsmail ; Yazıcıoğlu, Burcu ; Paglialonga, Fabio ; Vondrak, Karel ; Guzzo, Isabella ; Printza, Nikoleta ; Zagożdżon, Ilona ; Zurowska, Aleksandra ; Atmış, Bahriye ; Bayazıt, Aysun Karabay ; Tkaczyk, Marcin ; Faria, Maria do Sameiro ; Zaloszyc, Ariane ; Jankauskienė, Augustina ; Ekim, Mesiha ; Edefonti, Alberto ; Shroff, Rukshana ; Bakkaloğlu, Sevcan A |
| DOI |
10.1093/ckj/sfaf401 |
| Full Text |
|
| Is Part of |
Clinical kidney journal.. Oxford : Oxford University Press. 2026, vol. 19, iss. 3, art. no. sfaf401, p. [1-14].. ISSN 2048-8505. eISSN 2048-8513 |
| Keywords [eng] |
children ; dialysis ; hospitalization ; readmission ; risk factors |
| Abstract [eng] |
Background Limited data exist on rehospitalization in paediatric dialysis patients. The objective of this study was to identify indications, rates and risk factors for 30-day readmissions in this population. Methods We used a prospective multinational, multicentre cohort study of haemodialysis (HD) and peritoneal dialysis (PD) patients discharged between July 2017 and July 2018. Readmission was identified as repeat hospitalization within 30 days of a prior (index) admission. Potentially preventable readmissions were clinically related to the initial admission. Early readmissions were those occurring within 7 days of discharge. The primary outcome was 30-day readmission. Secondary outcomes included potentially avoidable and early readmissions. Results A total of 54 (31%) of 176 patients (102 PD, 74 HD) had at least one readmission; 84 (18%) discharges were followed by readmission. PD and HD patients had similar readmission rates {30.4% versus 31.1%; hazard ratio [HR] 1.06 [95% confidence interval (CI) 0.61–1.81]}. Compared with PD, HD patients had a significantly shorter time to readmission (8 versus 14 days; P =.019), higher early readmission rates (46% versus 18%; P =.010) and risk [odds ratio (OR) 3.87 (95% CI 1.35–11.11)]. Main readmission causes were dialysis access–related non-infectious complications (31%) and access infections (22.7%); 47% of readmissions were potentially avoidable. Lower haemoglobin levels were linked to readmission [HR 0.78 (95% CI 0.64–0.95)]. Bicarbonate use was associated with a 51% lower readmission risk [HR 0.49 (95% CI 0.24–0.99)]. Neurological comorbidity [OR 7.00 (95% CI 1.04–47.22)] and partial recovery [OR 56.45 (95% CI 3.02–1053.10)] were risk factors for avoidable readmission. Risk of avoidable and early readmission decreased with age [OR 0.98 (95% CI 0.97–0.99) and OR 0.99(95%CI 0.98–0.99), respectively]. Conclusions Readmissions are common in paediatric dialysis patients, with a substantial proportion being potentially preventable. To reduce rehospitalizations, interventions should target modifiable factors such as access complications, anaemia and incomplete recovery at discharge, while recognizing non-modifiable risks like HD and younger age to identify high-risk patients. |
| Published |
Oxford : Oxford University Press |
| Type |
Journal article |
| Language |
English |
| Publication date |
2026 |
| CC license |
|
