METHODS: This study is a retrospective analysis of hospital inpatient and discharge data from hospitals across the state, many in remote areas of New Mexico. Discharge data from 2014 was analyzed, the primary outcomes for this analysis were 1) hospitalizations with CKD and 2) hospitalizations with CKD and other chronic conditions. Definitions for chronic conditions were taken from the Centers for Medicaid and Medicare Services and were based on diagnosis codes (27 conditions).
RESULTS: In 2014, there were 28,473 (14.6%) hospitalizations for CKD. This is a 6.0% increase in the number of CKD hospitalizations from 2013. Patients 65+ years represented the largest group (59.6% of all CKD hospitalizations). Fifty-one percent of the hospitalizations occurred among male patients. Only 5.7% of patients solely suffered from CKD, 70.3% of CKD patients suffered from 4 or more chronic health conditions. The most prevalent dyads with CKD among 19-49 year olds were hypertension and anemia, and among 50-64 year olds and 65+ year olds were hypertension and diabetes. The 50-64 year old cohort had the highest percentage of multiple readmissions (31.9%).
CONCLUSIONS: One of the goals of Health People 2020 is to reduce the number of new cases of CKD and its complications, disability, death, and economic costs. Although genetic determinants play a large role in the development and progression of CKD, lifestyle factors and disease interactions (diabetes and hypertension) also play a role in disease progression and these factors can be modified by both the patient and the health system. Identifying individuals who are at the greatest risk, either based on the disease stage or by the fact that the patient suffers from multiple chronic conditions (indication of poor health), are the patients to target for intervention. A limitation of this analysis is the reliance on diagnosis codes for disease status.