Could Rescheduling a Missed Dialysis Appointment Lessen Hospitalization Risk?

Although rescheduling a missed hemodialysis appointment can help reduce the risk of subsequent hospitalization, it likely cannot eliminate this risk, according to new research presented at the American Society of Nephrology’s Kidney Week 2018.

These findings emerged from a retrospective study of electronic health records and 2014 US Renal Data System claims. Eligible participants were categorized based on treatment attendance, and those who did not attend were classified as having rescheduled or missed their appointment based on whether or not they dialyzed the next day.

In other analyses, propensity scores and index day of week were used to match patients who rescheduled or missed an appointment with patients who attended (1:5). Hospitalization, which was taken into account over the following 7 to 30 days or until censoring, was compared via generalized linear models.

Results of the study indicated that missing a hemodialysis treatment (n=4145) was associated with 100% and 39% higher rates of hospitalization in the 7 and 30 days, respectively, following a missed appointment compared with attending treatment (n=20,725).

Other notable findings were that attending a rescheduled treatment one day after missing a treatment (n = 2308) was associated with 49% and 31% higher rates of hospitalization over the next 7 and 30 days, respectively, compared with attending treatment (n=11,540).

“Rescheduling treatment attenuated but did not fully mitigate the hospitalization risk imposed by a missed treatment,” the researchers concluded.

—Christina Vogt

Reference:

Cohen DE, Gray KS, Colson C, Van Wyck DB, Tentori F, Brunelli SM. Impact of rescheduling a missed hemodialysis treatment on clinical outcomes. Paper presented at: American Society of Nephrology Kidney Week 2018; October 23-28, 2018; San Diego, CA.