PERFIL CLÍNICO E CAUSAS DE REINTERNAÇÃO EM PACIENTES COM DOENÇA RENAL CRÔNICA EM HEMODIÁLISE EM HOSPITAL TERCIÁRIO PÚBLICO: UM ESTUDO RETROSPECTIVO

Introduction: Hospital readmission of patients with Chronic Kidney Disease (CKD) on hemodialysis is a major challenge related to vascular access complications. This study described the clinical-epidemiological profile and causes of readmission in a cohort of patients at a tertiary hospital. Methods: This retrospective observational study analyzed 144 hospitalizations of 51 CKD patients with multiple admissions in 2024. Sociodemographic data, comorbidities, type of vascular access, and causes of hospitalization were collected. Statistical analyses included association tests and median comparisons. Results: The mean age was 61.5 years, with a predominance of hypertension (92.2%) and diabetes (66.7%). Temporary non-tunneled central venous catheters (Shiley type) were the most common access (54.9%), with a decreasing proportion of arteriovenous fistulas (AVFs) over time. The main causes of hospitalization were access dysfunction (56.9%) and access-related infection (15.3%). Length of stay was longer among tunneled cuffed catheter (Permcath) users (19.0 days). Overall mortality was 13.7%, mainly due to sepsis. Patients with AVFs had a higher proportional mortality rate, linked to more fragile clinical profiles. Conclusion: Vascular access complications, particularly among catheter users, were the leading cause of readmission. Reliance on catheters over definitive accesses highlights weaknesses in outpatient care. Integrated care strategies, focusing on vascular access planning and preservation, are essential to reduce morbidity and mortality and improve outcomes in this vulnerable population.