E0613 - Rates of Gastrointestinal Hospitalizations in Adults With Chronic Kidney Disease

Award: Presidential Poster Award

Mahnur Haider, MD¹, Robin L. Baudier, MSPH², Vecihi Batuman, MD¹, Anand Srivastava, MD, MPH³, Matthew Weir, MD⁴, Amanda H. Anderson, PhD, MPH^1
1Tulane University, New Orleans, LA; ²Tulane University School of Public Health and Tropical Medicine, New Orleans, LA; ³Northwestern University Feinberg School of Medicine, Chicago, IL; ⁴University of Maryland, Baltimore, MD

Introduction: Adults with chronic kidney disease (CKD) have a higher rate of hospitalizations than those without CKD. Gastrointestinal (GI) hospitalizations have not been well-described in this population. This study describes the burden and factors associated with GI hospitalizations in adult men and women with CKD.

Methods: Participants were enrolled between 2003 and 2008 in the Chronic Renal Insufficiency Cohort Study (CRIC), a prospective cohort of adult men and women with non-dialysis dependent CKD. First position International Classification of Diseases-9 or -10 discharge codes were used to identify the cause of a hospitalization using an Agency for Healthcare Research and Quality classification scheme, including ‘diseases of the digestive system’ for GI hospitalizations. Participants were followed until onset of end-stage kidney disease, withdrawal, death, or end of follow-up. A GI readmission was a subsequent GI admission, and a 30-day GI readmission was within 30 days of discharge. Unadjusted and age, sex, race/ethnicity adjusted rates of hospitalizations and differences in rates compared across subgroups of baseline characteristics were calculated using Poisson regression.

Results: Among 3,939 CRIC Study participants followed for a median of 9.6 years, there were 2,212 GI hospitalizations. The mean length of stay for a GI hospitalization was 4.5 days (95% CI: 4.3, 4.7). The unadjusted hospitalization rate per 100 person-years (95% CI) was 6.0 (5.8, 6.3) for all GI hospitalizations, 0.8 (0.7, 0.9) for GI hemorrhage, 0.8 (0.7, 0.9) for upper GI causes, 1.2 (1.1, 1.4) for lower GI causes and 1.0 (0.9, 1.1) for liver, pancreatic, and biliary causes. The unadjusted GI readmission and 30-day GI readmission rate per 100 person-years (95% CI) was 3.0 (2.8, 3.2) and 0.6 (0.6, 0.7), respectively. Higher rates of GI hospitalizations were seen with worsening kidney function measures, which included worsening eGFR and albuminuria, as well as in non-Hispanic Blacks, in participants with anemia and those who were underweight (Table). Participants with a history of hypertension, diabetes, nausea, vomiting, heartburn, diarrhea, constipation, use of proton pump inhibitors and anticoagulation also had higher rates of GI hospitalizations.

Discussion: Participants with eGFR < 30 ml/min/1.73m² and albuminuria of ≥ 1000 mg/day had the highest rates of GI hospitalizations. Further investigation of the interplay between CKD risk factors and GI outcomes may help reduce hospitalizations in this high-risk population.



Disclosures:


Mahnur Haider, MD¹, Robin L. Baudier, MSPH², Vecihi Batuman, MD¹, Anand Srivastava, MD, MPH³, Matthew Weir, MD⁴, Amanda H. Anderson, PhD, MPH¹. E0613 - Rates of Gastrointestinal Hospitalizations in Adults With Chronic Kidney Disease, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.