CAUSES OF HOSPITAL ADMISSION AMONG ADULTS WITH CHRONIC KIDNEY DISEASE IN A PANAMA CITY TERTIARY-CARE CENTER.

Abstract

BACKGROUND: Chronic kidney disease (CKD) confers a significant social burden and high health costs. In Panama the prevalence is 12.6% and it causes 2.8% of annual deaths. People with renal insufficiency are susceptible to complications and hospitalizations. We aimed to determine the main causes of admission in adults with chronic kidney disease.

METHODS: Descriptive, cross-sectional, retrospective observational study on patients > 18 years old with a previous diagnosis of CKD hospitalized in the Internal Medicine Service of the Dr. Arnulfo Arias Madrid Hospital Complex in 2018 and 2019. Information was collected from clinical records on age, sex, residence, type of renal replacement therapy, comorbidities, substance abuse and admission diagnosis (infectious vs. non-infectious causes).

RESULTS: Of the 131 cases described, 75 (57.25%) belonged to male sex and 103 (78.63%) were over 45 years of age. Hypertension and diabetes were the most common comorbidities. Ninety people were on renal replacement therapy (68.7%), of which, 83 received hemodialysis. Infectious causes were the main reason for admission (51.14%). Among non-infectious etiologies, cardiovascular events had a high prevalence (28.24%), followed by venous thromboembolism (4.56%). Patients with CKD - S5 on dialysis were admitted more for infectious causes and have a lower probability of hospitalization for decompensated heart failure than the group with CKD - S5 on medical treatment (OR 0.244 (0.062 - 0.958), 95% CI, p 0.043).

CONCLUSION: In our population, individuals with chronic kidney disease are hospitalized mainly for infectious causes. The CKD – S5 on renal replacement therapy subgroup have a lower probability of admission for heart failure than CKD patients who do not receive dialysis.