Diabetes as the Cause of End-Stage Renal Disease Affects the Pattern of Post Kidney Transplant Rehospitalizations

Ramezani, Majid; Ghoddousi, K.; Hashemi, M.; Khoddami-Vishte, H.-R.; Fatemizadeh, Somayeh; Saadat, Seyed Hassan; Khedmat, Hossein; Naderi, Majid

doi:10.1016/j.transproceed.2007.03.074

Cited by 25 publications

(9 citation statements)

References 23 publications

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“…Several analyses have also identified additional risk factors, including frailty, waiting list time, weekend discharges and initial LOS. [27][28][29][30][31] Our study did not have data on frailty, waiting list time or discharge day of the week, nor was LOS a risk factor in our study. This may be due to the short LOS in our study coupled with our program's enduring focus on structured care models within the outpatient setting to reduce both LOS and readmissions.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Kidney Allograft Survival in Patients With Transplant Glomerulitis

Nabokow¹,

Добронравов

Khrabrova

et al. 2015

Transplantation

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Section: Discussionmentioning

confidence: 99%

Long-Term Kidney Allograft Survival in Patients With Transplant Glomerulitis

Nabokow¹,

Добронравов

Khrabrova

et al. 2015

Transplantation

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“…There are limited data available regarding the prevalence of hyperglycemia after kidney transplantation among Iranian transplant recipients (3, 14-16). Therefore, we aimed to evaluate the frequency of hyperglycemia in renal transplant patients and it’s risk factors in a large renal transplanted population in Iran.…”

Section: Objectivesmentioning

confidence: 99%

Hyperglycemia After Renal Transplantation: Frequency and Risk Factors

et al. 2013

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BackgroundChronic renal failure is an important and common complication of diabetes mellitus; hence, renal transplantation is a frequent and the acceptable treatment in patients with diabetic nephropathy requiring renal replacement therapy. On the other hand, renal transplantation and its conventional treatment can lead to increased diabetes outbreak in normoglycemic recipients. Also, uncontrolled hyperglycemia may be increased and allograft lost thus decreasing patient survival.ObjectivesWe aimed to assess the frequency of hyperglycemia in transplant patients and its risk factors.Patients and MethodsA large retrospective study was performed on 3342 adult kidney transplant recipients between 2008 and 2010. Demographic and laboratory data were gathered for each patient. All tests were done in a single laboratory and hyperglycemia was defined as a fasting plasma glucose of > 125 mg/dL. Univariate and multivariate logistic regression analyses were used to determine the risk factors of hyperglycemia following kidney transplantation.ResultsThere were 2120 (63.4%) males and 1212 (36.3%) females. Prevalence of hyperglycemia was 22.5%. By univariate linear regression, hyperglycemia was significantly higher in patients with CMV infection (P = 0.001), elevated serum creatinine (P = 0.000), low HDL (P = 0.01), and increased blood levels of cyclosporine (P = 0.000). After adjusting for covariates by multivariate logistic regression, the hyperglycemia rate was significantly higher for patients with Cyclosporine trough level > 250 (P = 0.000), serum creatinine > 1.5 (P = 0.000) and HDL < 45 (P = 0.03).ConclusionsThis study indicated that hyperglycemia is a common metabolic disorder in Iranian kidney transplant patients. Risk factors for hyperglycemia were higher Cyclosporine level, impaired renal function, and reduced HDL value.

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“…18 In patients with diabetes, comorbidities that were predictors of readmission following hospitalization on internal medicine services at a single center include a history of CHF, renal dysfunction, anemia, and atrial fibrillation. 20 As a comorbidity itself, diabetes is associated with increased readmission following hospitalization for CHF, 21,22 renal transplant, 23 cardiac surgery, [24][25][26] and coronary artery bypass surgery with preexisting left ventricular dysfunction 27 ( Table 2). …”

Section: Role Of Diabetes Diagnosismentioning

confidence: 99%

The Effect of Diabetes on Hospital Readmissions

Dungan

2012

J Diabetes Sci Technol

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Abbreviations: (CHF) congestive heart failure, (DKA) diabetic ketoacidosis, (HbA1c) hemoglobin A1cKeywords: glycemic control, hemoglobin A1c, hospital, inpatient, readmission, rehospitalization AbstractHospital readmission is an important contributor to total medical expenditures and is an emerging indicator of quality of care. Diabetes, similar to other chronic medical conditions, is associated with increased risk of hospital readmission. Risk factors include previous hospitalization, extremes in age, and socioeconomic barriers. Preliminary studies suggest that acute and/or chronic glycemic control may be of importance when diabetes is the primary diagnosis or when it is a comorbidity. Very limited evidence from prospective randomized controlled trials aimed at improving glycemic control is available. However, whether one concludes that inpatient or outpatient glycemic control is partly responsible for reduced hospitalizations, attention to glycemic control in the hospital may facilitate sustained glycemic control post-discharge. Limited prospective and retrospective evidence suggest that the involvement of a diabetes specialist team may improve readmission rates, but attention to more generalized comprehensive approaches may also be worthwhile. Prospective interventional studies targeting interventions for improving glycemic control are needed to determine whether glycemic control impacts readmission rates.

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Diabetes as the Cause of End-Stage Renal Disease Affects the Pattern of Post Kidney Transplant Rehospitalizations

Cited by 25 publications

References 23 publications

Long-Term Kidney Allograft Survival in Patients With Transplant Glomerulitis

Long-Term Kidney Allograft Survival in Patients With Transplant Glomerulitis

Hyperglycemia After Renal Transplantation: Frequency and Risk Factors

The Effect of Diabetes on Hospital Readmissions

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