Hospitalized patients with chronic kidney disease (CKD) face a higher risk of harm from medical errors than patients without the disease. In data from about 250,000 hospitalized patients in the Veterans Health Administration in 2004 and 2005, 29% of patients had CKD. These patients had a higher-than-normal risk for several patient-safety indicators (PSI), conditions specified by the Agency for Healthcare Research and Quality to monitor rates of adverse events in hospitalized patients. These include complications of anesthesia, postoperative hip fracture, postoperative physiologic or metabolic disturbances, and postoperative respiratory failure. But the riskiest PSIs for patients with CKD were infections due to medical care and death during hospitalization for a condition that isn't considered to have a high mortality risk. As preadmission estimated glomerular filtration rates decreased, researchers found a significant trend toward increased risk for all PSI. "Further investigation is needed to develop and test interventions to reduce this risk," the researchers write.
Seliger SL, Zhan M, Hsu VD, Walker LD, Fink JC. Chronic kidney disease adversely influences patient safety. J Am Soc Nephrol. http://jasn.asnjournals.org. Accessed September 5, 2008.