Background: It is well-documented that chronic kidney disease (CKD) often results in end-stage renal failure and\nputs patients at extremely high risk for developing cardiovascular disease. Educational hospitalization at medical\ninstitutions in Japan is important for patients with CKD because it facilitates treatment in earlier stages of CKD\nwhen subjective symptoms are not apparent. However, some patients who have achieved their educational targets\ntend to have poor compliance at home after discharge from the hospital, resulting in rehospitalization shortly. In\nthis study, we examined the factors for early rehospitalization of patients after initial CKD educational hospitalization\ncompared with non-rehospitalized patients.\nMethods: One hundred thirty-seven patients after discharge from CKD educational hospitalization in Japan\nbetween March 2011 and December 2012 were included in the analyses. The subjects were classified into two\ngroups: the early rehospitalization group and control group. We adjusted for confounding variables and performed\nmultiple logistic regression analysis with the presence or absence of early rehospitalization as a dependent variable\nto investigate the association of early rehospitalization with patient background features, laboratory data, vital signs,\ninstruction-related items, and home environment.\nResults: Study subjects included 22 patients in the early hospitalization group and 115 patients in control group.\nMultivariable analysis for early rehospitalization indicated that insufficient instruction by physician, pharmacist, and\ndietitians was independent explanatory variable. Analyzing by Kaplanââ?¬â??Meier method, the probability of nonrehospitalization\nin the instruction group was significantly higher than that in the non-instruction group. Therefore,\nwe believe it is necessary to involve a competent, multidisciplinary medical team (consisting of physicians,\npharmacists, and dietitians) in addressing the early rehospitalization issue in patients with CKD.\nConclusion: These findings confirm the importance of care by a multidisciplinary medical team in patients with\nCKD. Therefore, we suggest that care by a multidisciplinary medical team reduces the increase of early\nrehospitalization in patients with CKD.
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