{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T11:31:30Z","timestamp":1758281490421,"version":"3.44.0"},"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Individuals with end-stage renal disease (ESRD) hospitalized for COVID-19 may have a higher risk for adverse post discharge events. To investigate these risks, we examined a large database of individuals admitted for COVID-19 and discharged alive, to see if ESRD was independently associated with higher risk for death within 180 days or for 30-day hospital readmission.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We retrospectively compared risks for hospital, non-hospital, and overall death within 180 days and 30-day hospital readmission between individuals with and without ESRD. We studied individuals hospitalized with COVID-19 between January 6, 2020 and August 3, 2023, at any of the 5 University of California medical centers and discharged alive.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 11,406 individuals hospitalized with COVID-19 who were discharged alive, 713 (6.3%) had ESRD. Compared to individuals without ESRD, those with ESRD had a significantly higher hazard of hospital and overall death within 180 days post-discharge in the unadjusted analyses, but not in the analyses adjusted for demographic variables, hospitalization period, and comorbid conditions (adjusted Wald chi-square hazard ratio (HR) 1.36, 95% Wald CI 0.78\u20132.37; adjusted HR 1.05, 95% CI 0.73\u20131.51, respectively). Those with ESRD did not have a significantly higher hazard of non-hospital death within 180 days post-discharge in either the unadjusted or the adjusted analyses (adjusted HR 0.89, 95% CI 0.55\u20131.44), but did have a significantly higher hazard of 30-day hospital readmission in both the unadjusted and the adjusted analyses (adjusted HR 1.36, 95% CI 1.14\u20131.63, p\u2009=\u20090.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>ESRD patients hospitalized with COVID-19 had a higher unadjusted risk of hospital and overall death within 180 days and of 30-day hospital readmission than individuals without ESRD. After adjusting for demographic factors, hospitalization period, and comorbidities, presence of ESRD was not found to significantly increase the risk for hospital, non-hospital, or overall death within 180 days post-discharge, but was found to significantly increase the risk of 30-day hospital readmission.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0332203","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T17:42:36Z","timestamp":1758217356000},"page":"e0332203","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse outcomes post-COVID-19 hospitalization among ESRD patients: A retrospective cohort study in 5 California university medical centers"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3025-8737","authenticated-orcid":true,"given":"Marc","family":"Reiterman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew I.","family":"Chin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heejung","family":"Bang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"issue":"6","key":"pone.0332203.ref001","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1016\/j.kint.2020.07.030","article-title":"Outcomes of patients with end-stage kidney disease hospitalized with COVID-19","volume":"98","author":"Northwell COVID-19 Research Consortium and the Northwell Nephrology COVID-19 Research Consortium","year":"2020","journal-title":"Kidney Int"},{"key":"pone.0332203.ref002","first-page":"471","volume-title":"Epidemiology of Chronic Disease: Global Perspectives","author":"RE Harris","year":"2013"},{"issue":"6","key":"pone.0332203.ref003","doi-asserted-by":"crossref","first-page":"2508","DOI":"10.1111\/j.1523-1755.2005.00364.x","article-title":"Bacterial infections in hemodialysis patients: pathogenesis and prevention","volume":"67","author":"BL Jaber","year":"2005","journal-title":"Kidney Int"},{"issue":"1","key":"pone.0332203.ref004","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1053\/j.jrn.2011.10.020","article-title":"Effect of uremia on structure and function of immune system","volume":"22","author":"ND Vaziri","year":"2012","journal-title":"J Ren Nutr"},{"issue":"8","key":"pone.0332203.ref005","doi-asserted-by":"crossref","first-page":"2378","DOI":"10.1007\/s11606-021-06924-0","article-title":"Thirty-Day Post-Discharge Outcomes Following COVID-19 Infection","volume":"36","author":"JR Kingery","year":"2021","journal-title":"J Gen Intern Med"},{"issue":"10","key":"pone.0332203.ref006","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1093\/cid\/ciab464","article-title":"Factors Associated With Readmission in the United States Following Hospitalization With Coronavirus Disease 2019","volume":"74","author":"EC Verna","year":"2022","journal-title":"Clin Infect Dis"},{"issue":"10","key":"pone.0332203.ref007","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1080\/23744235.2021.1924398","article-title":"Characteristics of patients discharged and readmitted after COVID-19 hospitalisation within a large integrated health system in the United States","volume":"53","author":"C-W Huang","year":"2021","journal-title":"Infect Dis (Lond)"},{"key":"pone.0332203.ref008","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.ajem.2021.12.012","article-title":"Characteristics, risk factors, and outcomes associated with readmission in COVID-19 patients: a systematic review and meta-analysis","volume":"52","author":"A Akbari","year":"2022","journal-title":"Am J Emerg Med"},{"issue":"6","key":"pone.0332203.ref009","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.34067\/KID.0000242022","article-title":"The impact of COVID-19 on postdischarge outcomes for dialysis patients in the United States: evidence from medicare claims data","volume":"3","author":"W Wu","year":"2022","journal-title":"Kidney360"},{"issue":"3","key":"pone.0332203.ref010","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1001\/jama.2020.21465","article-title":"Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system","volume":"325","author":"JP Donnelly","year":"2021","journal-title":"J Am Med Assoc"},{"key":"pone.0332203.ref011","unstructured":"University of Wisconsin School of Medicine and Public Health. 2020 Area Deprivation Index. 2020. [cited 2023 Oct 15] Available from: https:\/\/www.neighborhoodatlas.medicine.wisc.edu"},{"issue":"26","key":"pone.0332203.ref012","doi-asserted-by":"crossref","first-page":"2456","DOI":"10.1056\/NEJMp1802313","article-title":"Making neighborhood-disadvantage metrics accessible - the neighborhood atlas","volume":"378","author":"AJH Kind","year":"2018","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0332203.ref013","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1681\/ASN.2018080858","article-title":"Prior hospitalization burden and the relatedness of 30-day readmissions in patients receiving hemodialysis","volume":"30","author":"E Lin","year":"2019","journal-title":"J Am Soc Nephrol"},{"key":"pone.0332203.ref014","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.cytogfr.2020.05.002","article-title":"COVID-19: pathogenesis, cytokine storm and therapeutic potential of interferons","volume":"53","author":"SH Nile","year":"2020","journal-title":"Cytokine Growth Factor Rev"},{"key":"pone.0332203.ref015","article-title":"Crisis standards of care and COVID-19: what did we learn? 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What should we do?","volume":"2021","author":"JL Hick","year":"2021","journal-title":"NAM Perspect"},{"issue":"3","key":"pone.0332203.ref016","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s40620-023-01596-x","article-title":"Risks of in-hospital death and hospital length of stay of 7 days or longer among end-stage renal disease patients hospitalized with COVID-19: a retrospective cohort study in five California medical centers","author":"M Reiterman","year":"2023","journal-title":"J Nephrol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0332203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T17:42:42Z","timestamp":1758217362000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0332203"}},"subtitle":[],"editor":[{"given":"Ankur","family":"Shah","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":16,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0332203","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,18]]}}}