Frequency and Causes of Hospital Re-Admissions among Post-Kidney Transplant Recipients at Specialized Centers in Khartoum, Sudan: A Cross-Sectional Study

Abstract

Background : Hospital readmissions after kidney transplantation are common and may predict future adverse outcomes. Previous studies using claims data have been limited. A better understanding of the risk factors associated with readmissions is necessary to develop accurate predictive models. Objective and Rationale : To determine the frequency, causes, and duration of hospital readmissions among post-kidney transplant recipients in specialized centers in Khartoum State, Sudan. Study Design : A descriptive, cross-sectional study. Setting and Participants : Three hundred post-kidney transplant recipients at Ahmed Gasim and Ibn Sina centers were enrolled in this study. Data on recipient, donor, and transplantation characteristics were collected. Readmission frequency, duration, causes, sites, and length of hospital stay were recorded using structured questionnaires and medical record reviews. Results: The hospital readmission rate was 39% (n = 117). Of these, 72.6% (n = 85) were readmitted only once, and infection was the leading cause of readmissions. Recipient male gender (P-value = 0.031), high body mass index (P-value = 0.014), chronic lung diseases and diabetes mellitus among comorbidities (P-value = 0.000), prior dialysis before kidney transplantation, especially peritoneal dialysis and peritoneal combined hemodialysis (P-value = 0.003), missed post-transplantation follow-up (P-value = 0.000), older-aged donor above 60 years (P-value = 0.003), kidney transplantation from second-degree related donors (P-value = 0.034), and intermediate & high immunological risks (P-value = 0.000) were major predisposing factors for hospital readmission post kidney transplantation. Conclusion : The hospital readmission rate after kidney transplantation among Sudanese recipients was high and mainly due to infection; a specific preventive program based on infection prevention and graft function monitoring should be established.