title: Medication Intervention for Chronic Kidney Disease Patients Transitioning from Hospital to Home: Study Design and Baseline Characteristics.
abstract: The hospital readmission rate in the population with chronic kidney disease (CKD) is high and strategies to reduce this risk are urgently needed.
  
  
  
  The CKD-Medication Intervention Trial (CKD-MIT; www.clinicaltrials.gov; NCTO1459770) is a single-blind (investigators), randomized, clinical trial conducted at Providence Health Care in Spokane, Washington. Study participants are hospitalized patients with CKD stages 3-5 (not treated with kidney replacement therapy) and acute illness. The study intervention is a pharmacist-led, home-based, medication management intervention delivered within 7 days after hospital discharge. The primary outcome is a composite of hospital readmissions and visits to emergency departments and urgent care centers for 90 days following hospital discharge. Secondary outcomes are achievements of guideline-based targets for CKD risk factors and complications.
  
  
  
  Enrollment began in February 2012 and ended in May 2015. At baseline, the age of participants was 69 ± 11 years (mean ± SD), 50% (77 of 155) were women, 83% (117 of 141) had hypertension and 56% (79 of 141) had diabetes. At baseline, the estimated glomerular filtration rate was 41 ± 14 ml/min/1.73 m2 and urine albumin-to-creatinine ratio was 43 mg/g (interquartile range 8-528 mg/g). The most frequent diagnosis category for the index hospital admission was cardiovascular diseases at 34% (53 of 155), but the most common single diagnosis for admission was community-acquired acute kidney injury at 10% (16 of 155).
  
  
  
  Participants in CKD-MIT are typical of acutely ill hospitalized patients with CKD. A medication management intervention after hospital discharge is under study to reduce post-hospitalization acute care utilization and to improve CKD management.
authors.affiliation: Providence Health Care, University of Washington School of Medicine, Spokane, Wash., USA.
authors.forename: Radica Z
authors.initials: RZ
authors.lastname: Alicic
authors.forename: Robert A
authors.initials: RA
authors.lastname: Short
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Corbett
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Neumiller
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Gates
authors.forename: Kenn B
authors.initials: KB
authors.lastname: Daratha
authors.forename: Celestina
authors.initials: C
authors.lastname: Barbosa-Leiker
authors.forename: Sterling
authors.initials: S
authors.lastname: McPherson
authors.forename: Naomi S
authors.initials: NS
authors.lastname: Chaytor
authors.forename: Brad P
authors.initials: BP
authors.lastname: Dieter
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Setter
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Tuttle
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000150:complications / Q000628:therapy*; D015897:Comorbidity; D003404:Creatinine / Q000652:urine; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010360:Patient Transfer / Q000379:methods*; D010595:Pharmacists; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D012307:Risk Factors; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D003404:Creatinine