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Abstract
Background:
Chronic kidney disease (CKD) is a condition that is characterized by high morbidity and use of healthcare, especially through frequent hospitalization. Recurring admissions indicate instability of diseases, comorbidity, and poor outpatient care. It is necessary to find modifiable determinants of repeated hospitalization among non-dialysis-dependent CKD patients to enhance clinical outcomes and decrease the cost of healthcare.
Materials and Methods:
This case-control study will be carried out in the Department of Nephrology, Khyber Teaching Hospital, between 1st September 2024 and 28th February 2025. Two hundred and eight CKD patients were recruited with 104 cases having repeated hospitalization and 104 controls of the same age without repeated hospitalization. Determinants measured consisted of anemia, cardiovascular illness and poor medication adherence. The SPSS version 25 was used to analyze the data. Associations were compared through Chi-square test and odds ratios (OR) with 95% confidence interval (CI) were determined. The p-value of less than 0.05 was taken as statistically significant.
Results:
The incidence of anemia was 51.9 per cent versus 26.9 per cent in cases versus controls respectively (OR = 2.93; 95% CI: 1.63525). The proportion of cardiovascular illness was found to be 58.7 per cent as compared to 30.8 per cent of the controls (OR = 3.19; 95% CI: 1.805.65; p =0.001). There were higher reports of poor medication adherence at 36.5 versus 15.4 among the cases and controls respectively (OR = 3.12; 95% CI: 1.56-6.22; p <0.001). The significance of all determinants was maintained once they had been stratified against the possible confounders.
Conclusion:
Heavy hospitalization in non-dialysis dependent CKD patients is majorly determined by anemia, cardiovascular disease and inability to take medication properly. Focused treatment of these factors adjustable to change can contribute to the decrease in the number of repeat admissions and patient outcomes.