Skip to main content
Journal cover image

Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD.

Publication ,  Journal Article
Srivastava, A; Cai, X; Mehta, R; Lee, J; Chu, DI; Mills, KT; Shafi, T; Taliercio, JJ; Hsu, JY; Schrauben, SJ; Saunders, MR; Diamantidis, CJ ...
Published in: Kidney Int Rep
June 2021

INTRODUCTION: Management of chronic kidney disease (CKD) entails high medical complexity and often results in high hospitalization burden. There are limited data on the associations of longitudinal hospital utilization patterns with adverse clinical outcomes in individuals with CKD. METHODS: We derived cumulative all-cause hospitalization trajectory groups using latent class trajectory analysis in 3012 participants of the Chronic Renal Insufficiency Cohort (CRIC) Study who were alive and did not reach end-stage kidney disease (ESKD) within 4 years of study entry. Cox proportional hazards models tested the associations between hospitalization trajectory groups and risks of ESKD and death prior to the onset of ESKD (ESKD-censored death). RESULTS: Within 4 years of study entry, there were 5658 hospitalizations among 3012 participants. We identified 3 distinct subgroups of individuals with CKD based on cumulative all-cause hospitalization trajectories over 4 years: low-utilizer (n = 1066), intermediate-utilizer (n = 1802), and high-utilizer (n = 144). High-utilizers represented a patient population of lower socioeconomic status who had a greater prevalence of comorbid conditions and lower kidney function compared with intermediate- and low-utilizers. After the 4-year ascertainment period to form the trajectory subgroups, there were 544 ESKD events and 437 ESKD-censored deaths during a median follow-up time of 5.1 years. Compared with low-utilizers, intermediate-utilizers and high-utilizers were at 1.49-fold (95% confidence interval [CI] 1.22-1.84) and 1.75-fold (95% CI 1.20-2.56) higher risk of ESKD in adjusted analyses, respectively. Compared with low-utilizers, intermediate-utilizers and high-utilizers were at 1.48-fold (95% CI 1.17-1.87) and 2.58-fold (95% CI 1.74-3.83) higher risk of ESKD-censored death in adjusted analyses, respectively. CONCLUSIONS: Trajectories of cumulative all-cause hospitalization identify subgroups of individuals with CKD who are at high risk of ESKD and death.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Kidney Int Rep

DOI

EISSN

2468-0249

Publication Date

June 2021

Volume

6

Issue

6

Start / End Page

1592 / 1602

Location

United States

Related Subject Headings

  • 42 Health sciences
  • 32 Biomedical and clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Srivastava, A., Cai, X., Mehta, R., Lee, J., Chu, D. I., Mills, K. T., … CRIC Study Investigators, . (2021). Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD. Kidney Int Rep, 6(6), 1592–1602. https://doi.org/10.1016/j.ekir.2021.03.883
Srivastava, Anand, Xuan Cai, Rupal Mehta, Jungwha Lee, David I. Chu, Katherine T. Mills, Tariq Shafi, et al. “Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD.Kidney Int Rep 6, no. 6 (June 2021): 1592–1602. https://doi.org/10.1016/j.ekir.2021.03.883.
Srivastava A, Cai X, Mehta R, Lee J, Chu DI, Mills KT, et al. Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD. Kidney Int Rep. 2021 Jun;6(6):1592–602.
Srivastava, Anand, et al. “Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD.Kidney Int Rep, vol. 6, no. 6, June 2021, pp. 1592–602. Pubmed, doi:10.1016/j.ekir.2021.03.883.
Srivastava A, Cai X, Mehta R, Lee J, Chu DI, Mills KT, Shafi T, Taliercio JJ, Hsu JY, Schrauben SJ, Saunders MR, Diamantidis CJ, Hsu C-Y, Waikar SS, Lash JP, Isakova T, CRIC Study Investigators. Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD. Kidney Int Rep. 2021 Jun;6(6):1592–1602.
Journal cover image

Published In

Kidney Int Rep

DOI

EISSN

2468-0249

Publication Date

June 2021

Volume

6

Issue

6

Start / End Page

1592 / 1602

Location

United States

Related Subject Headings

  • 42 Health sciences
  • 32 Biomedical and clinical sciences