Key result
Use of renin-angiotensin blockers was associated with a reduced occurrence of 30-day hospital readmission (adjusted OR 0.39; 95% CI 0.19-0.79) in older adults with chronic kidney disease.
Why the study?
Are medication appropriateness, regimen complexity, or use of renin-angiotensin blockers associated with reduced hospital readmission in older adults with CKD?
Cohort (n=204)
No
Are medication appropriateness, regimen complexity, or use of renin-angiotensin blockers associated with reduced hospital readmission in older adults with CKD?
Odds Ratio: 0.39 (95% CI 0.19–0.79)
In older adults with CKD, the use of renin-angiotensin blockers is associated with a significant reduction in 30- and 90-day hospital readmissions, whereas overall medication appropriateness and regimen complexity are not.
May support renin-angiotensin blocker consideration at discharge in older CKD patients; hypothesis-generating pending randomized trials.
= 204) patients admitted to an Australian hospital. Medication appropriateness (Medication Appropriateness Index; MAI), medication regimen complexity (number of medications and Medication Regimen Complexity Index; MRCI) and use of selected medication classes were exposure variables. Outcomes were occurrence of readmission within 30 and 90 days, and time to readmission within 90 days. Logistic and Cox hazards regression were used to identify factors associated with readmission. Overall, 50 patients (24%) were readmitted within 30 days, while 81 (40%) were readmitted within 90 days. Mean time to readmission within 90 days was 66 (SD 34) days. Medication appropriateness and regimen complexity were not independently associated with 30- or 90-day hospital readmissions in older adults with CKD, whereas use of renin‒angiotensin blockers was associated with reduced occurrence of 30-day (adjusted OR 0.39; 95% CI 0.19⁻0.79) and 90-day readmissions (adjusted OR 0.45; 95% CI 0.24⁻0.84) and longer time to readmission within 90 days (adjusted HR 0.52; 95% CI 0.33⁻0.83). This finding highlights the importance of considering the potential benefits of individual medications during medication review in older CKD patients.
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Tesfaye et al. (2019) conducted a cohort in Chronic Kidney Disease (n=204). Renin-angiotensin blockers vs. Non-use was evaluated on 30-day hospital readmission (OR 0.39, 95% CI 0.19-0.79). Use of renin-angiotensin blockers was associated with a reduced occurrence of 30-day hospital readmission (adjusted OR 0.39; 95% CI 0.19-0.79) in older adults with chronic kidney disease.
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