Prolonged hospital stay has been identified as a major component in the increase of health care costs. Although some studies have described re-hospitalization after transplantation, few of them have focused on risk factors and consequences of prolonged hospital stay. Our goal was to determine the causes, risk factors and outcomes of prolonged re-hospitalizations following renal transplantation. 574 consecutive re-hospitalization records of kidney recipients in Baqyiatallah hospital from 1994 to 2006 were reviewed retrospectively. Admissions which lasted more than 14 days were considered as prolonged stay (PS). Demographic data, cause of End Stage Renal Disease (ESRD), cause of re-admission, ICU admission, time interval between transplantation and re-hospitalization and mortality were compared in two groups. 149 hospitalizations (26%) had a prolonged stay. ESRD secondary to diabetes was a risk factor for PS (28% vs 15.4%, p=0.006). Admissions due to infections (56.4% vs 42.4%, p=0.003) or renal dysfunctions (55% vs. 41.4%, p=0.004) caused a higher frequency of PS. Higher ICU admissions (8.8% vs 2.8%, p=0.002) and mortality (6.7% vs 3.05%, p=0.001) were also detected in those with PS.
Conclusion: In this study we found that diabetic kidney recipients are at higher risk of prolonged re-hospitalization. Infections and renal dysfunctions cause a higher number of prolonged re-hospitalizations. To reduce high costly and fatal prolonged re-hospitalizations, preventive strategies to decrease the rate of infections and renal dysfunctions in diabetic kidney transplant recipients seem to be helpful.