Hospital Outcomes Worse for Children With Chronic Kidney Disease

TUESDAY, Oct. 13, 2020 — Among children who are hospitalized, pediatric chronic kidney disease (CKD) is associated with longer length of stay (LOS) and increased costs compared with other chronic illnesses, according to a study published online Oct. 12 in the American Journal of Kidney Diseases.

Zubin J. Modi, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted a cross-sectional national survey of pediatric discharges to examine the association of CKD with hospital outcomes. Data were included for children with a chronic medical diagnosis included in the Health Cost and Utilization Project Kids Inpatient Database for 2006, 2009, 2012, and 2016.

The researchers found that during the study period, a chronic medical condition was present in 6,524,745 estimated discharges and CKD was present in 3.9 percent of discharges. LOS was longer for those with versus those without a CKD diagnosis (median, 2.8 versus 1.8 days). Compared with those without CKD, those with CKD had a higher median cost ($8,755 versus $5,016 per hospitalization). The presence of CKD was associated with longer LOS (29.9 percent), higher cost (61.3 percent), and higher mortality risk (odds ratio, 1.51).

“These outcomes seem to be due to the higher complexity of CKD discharges compared to discharges with other chronic illnesses. Investigation is needed to identify modifiable patient characteristics and health care delivery with the aim of developing and testing interventions to reduce the adverse health outcomes of pediatric CKD in the U.S.,” the authors write.

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