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Strategies to Reduce Rehospitalization in Patients with CKD and Kidney Failure

Simit Doshi and Jay B. Wish
CJASN February 2021, 16 (2) 328-334; DOI: https://doi.org/10.2215/CJN.02300220
Simit Doshi
Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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Jay B. Wish
Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
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Abstract

Readmissions in patients with nondialysis-dependent CKD and kidney failure are common and are associated with significant morbidity, mortality, and economic consequences. In 2013, the Centers for Medicare and Medicaid Services implemented the Hospital Readmissions Reduction Program in an attempt to reduce high hospitalization-associated costs. Up to 50% of all readmissions are deemed avoidable and present an opportunity for intervention. We describe factors that are specific to the patient, the index hospitalization, and underlying conditions that help identify the “high-risk” patient. Early follow-up care, developing volume management strategies, optimizing nutrition, obtaining palliative care consultations for seriously ill patients during hospitalization and conducting goals-of-care discussions with them, instituting systematic advance care planning during outpatient visits to avoid unwanted hospitalizations and intensive treatment at the end of life, and developing protocols for patients with incident or prevalent cardiovascular conditions may help prevent avoidable readmissions in patients with kidney disease.

  • chronic kidney disease
  • rehospitalization
  • kidney failure
  • Patient Readmission
  • Palliative Care
  • Medicare
  • Medicaid
  • Outpatients
  • hospitalization
  • Hospital Costs
  • Renal Insufficiency
  • Renal Insufficiency
  • Chronic
  • Patient Care Planning
  • Copyright © 2021 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology: 16 (2)
Clinical Journal of the American Society of Nephrology
Vol. 16, Issue 2
February 08, 2021
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Strategies to Reduce Rehospitalization in Patients with CKD and Kidney Failure
Simit Doshi, Jay B. Wish
CJASN Feb 2021, 16 (2) 328-334; DOI: 10.2215/CJN.02300220

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Strategies to Reduce Rehospitalization in Patients with CKD and Kidney Failure
Simit Doshi, Jay B. Wish
CJASN Feb 2021, 16 (2) 328-334; DOI: 10.2215/CJN.02300220
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    • Introduction
    • Strategies to Reduce Recurrent Hospitalization in Patients with Kidney Failure
    • Strategies to Reduce Recurrent Hospitalization in Patients with CKD
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More in this TOC Section

  • Integrating Patient Priorities with Science by Community Engagement in the Kidney Precision Medicine Project
  • Risk Factors for CKD Progression
  • NephroTalk Multimodal Conservative Care Curriculum for Nephrology Fellows
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Keywords

  • chronic kidney disease
  • rehospitalization
  • kidney failure
  • Patient Readmission
  • Palliative Care
  • Medicare
  • Medicaid
  • Outpatients
  • hospitalization
  • Hospital Costs
  • Renal Insufficiency
  • Chronic
  • Patient Care Planning

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