{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T19:46:56Z","timestamp":1775072816855,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Chronic kidney disease is associated with frequent readmissions for ambulatory\u2010sensitive conditions such as fluid overload. There is a paucity of literature to identify individuals at high risk of fluid overload or all\u2010cause readmissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a single\u2010centre retrospective cohort study involving 783 patients with an estimated glomerular filtration rate of 11\u201330\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      hospitalised for fluid overload between 2015 and 2017. Multivariable logistic regression analysis was performed to evaluate associations between the 30\u2010day fluid overload\u2010related and all\u2010cause readmissions and various sociodemographic factors, comorbidities and healthcare utilisation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 30\u2010day readmission rate for fluid overload and all causes were 10.6% and 26.8%, respectively. Fluid overload readmissions were associated with atherosclerotic cardiovascular disease (ASCVD; adjusted odds ratio [aOR] 1.81, 95% CI 1.08\u20133.03), atrial fibrillation (AF; aOR 1.93, 95% CI 1.13\u20133.30), higher serum potassium (aOR 1.61, 95% CI 1.14\u20132.26) and use of high\u2010dose intravenous furosemide during the index hospitalisation (aOR 1.66, 95% CI 1.02\u20132.67). In contrast, prior nephrology consult (aOR, 0.51, 95% CI 0.29\u20130.89) and renin\u2010angiotensin system (RAS) blocker prescription at discharge (aOR 0.61, 95% CI 0.38\u20130.99) were associated with reduced risk of readmission for fluid overload. More frequent emergency department visits (aOR 1.21, 95% CI 1.04\u20131.40) and higher LACE score (aOR 1.09, 95% CI 1.01\u20131.18) were independently associated with 30\u2010day readmission for all causes. Hypertension (aOR 0.62, 95% CI 0.42, 0.93), antidepressant use (aOR 0.40, 95% CI 0.16\u20130.99) and statin prescription at discharge (aOR 0.53, 95% CI 0.35\u20130.81) were associated with reduced risk for all\u2010cause readmissions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Factors related to comorbidity burden (ASCVD, AF, more frequent emergency department visits and higher LACE score) and disease severity (higher serum potassium and need for high\u2010dose intravenous furosemide) can identify individuals at increased risk of readmission. Further research is required to evaluate the impact of modifiable factors (nephrology consult, RAS blocker prescription at discharge and statin prescription at discharge) to reduce fluid overload\u2010related and all\u2010cause readmissions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70071","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T19:43:26Z","timestamp":1751226206000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hospital Readmissions for All\u2010Causes and Fluid Overload in Severely Reduced Kidney Function Not Requiring Dialysis\u2014A Retrospective Cohort Study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4659-4559","authenticated-orcid":false,"given":"Zheng Xi","family":"Kog","sequence":"first","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiashen","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"},{"name":"Medicine Academic Clinical Programme SingHealth Duke\u2010NUS Academic Medical Centre  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9531-7719","authenticated-orcid":false,"given":"Li Choo","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"},{"name":"Specialty Nursing Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihua","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"},{"name":"Specialty Nursing Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lydia","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicia","family":"Loo","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6742-7189","authenticated-orcid":false,"given":"Hanis Bte","family":"Abdul Kadir","sequence":"additional","affiliation":[{"name":"Health Services Research Unit Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8161-1679","authenticated-orcid":false,"given":"Jia Liang","family":"Kwek","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Choo","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lina","family":"Choong","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chieh Suai","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"},{"name":"Medicine Academic Clinical Programme SingHealth Duke\u2010NUS Academic Medical Centre  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0021-4861","authenticated-orcid":false,"given":"Cynthia C.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore"},{"name":"Medicine Academic Clinical Programme SingHealth Duke\u2010NUS Academic Medical Centre  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfx335"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8030395"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.2300"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f7171"},{"key":"e_1_2_10_6_1","unstructured":"National Population Health Survey 2023 \u201cEpidemiology & Disease Control Division Ministry of Health Republic of Singapore \u201d 2022."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.05.013"},{"key":"e_1_2_10_8_1","first-page":"434","article-title":"Trends in Fluid Overload\u2010Related Hospitalisations Among Patients With Diabetes Mellitus: The Impact of Chronic Kidney Disease","volume":"53","author":"Hak J. 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