接受维持性透析的肾衰竭患者平均每年去急诊室 (ED) 3 次，是普通人群的 3 至 8 倍。对于导致该人群中潜在可预防的 ED 使用的因素知之甚少。为了确定与接受维持性透析的患者中潜在可预防的 ED 使用相关的临床和社会人口学因素。这项队列研究使用了艾伯塔省肾脏疾病网络内的关联管理健康数据旨在识别2010年4月1日至2019年3月31日期间接受维持性透析（即血液透析或腹膜透析）的18岁或以上的成年人。对接受透析超过90天的患者从队列入组（定义透析开始日期加上 90 天）直至死亡、移出该省、接受肾移植或研究随访结束。安徒生卫生服务行为模型被用作概念框架，以确定与卫生保健需求、诱发因素和促成因素相关的变量。数据于 2024 年 3 月进行分析。计算了与 4 种肾脏疾病特异性门诊护理敏感病症（高钾血症、心力衰竭、容量超负荷和恶性高血压）相关的全因 ED 发病率和可能可预防的 ED 使用率。使用多变量负二项回归模型来检查临床和社会人口因素与潜在可预防的 ED 使用率之间的关联。该队列包括 4925 名成年人（平均 [SD] 年龄，60.8 [15.5] 岁；3071 名男性 [62.4%]）接受维持性血液透析（3183 名患者）或腹膜透析（1742 名患者）的肾衰竭患者的平均随访时间 (SD) 为 2.5 (2.0) 年。总共，3877 名患者有 34029 次全因急诊就诊（每 1000 人年有 3100 次 [95% CI，2996-3206] 次就诊）。其中，755 名患者 (19.5%) 发生了 1351 次可能可预防的 ED 遭遇（每 1000 人年 114 次 [95% CI，105-124] 次）。与发生不可预防的 ED 的患者相比，发生可预防的 ED 的患者更有可能处于收入最低的五分位（38.8% vs 30.9%；P < .001）；经历心力衰竭（46.8% vs 39.9%；P = .001）、抑郁（36.6% vs 32.5%；P = .03）和慢性疼痛（60.1% vs 54.9%；P = .01）；并有更长的透析时间（3.6 年 vs 2.6 年；P < .001）。在多变量回归分析中，年轻人（18 至 44 岁人群的发病率比 [IRR]，1.69 [95% CI，1.33-2.15]）和慢性疼痛患者（IRR，1.35 [ 95% CI, 1.14-1.61]）、更大的物质匮乏（IRR, 1.57 [95% CI, 1.16-2.12]）、高钾血症病史（IRR, 1.31 [95% CI, 1.09-1.58]）和历史高值使用 ED（即，前一年遇到 ≥ 3 次 ED；IRR，1.46 [95% CI，1.23-1.73）。在这项针对加拿大艾伯塔省接受维持性透析的成年人的研究中，在使用 ED 的患者中，五分之一的人曾一次可能可以预防的 ED 遭遇；此类遭遇的原因与社会心理和医疗因素有关。研究结果强调需要制定解决健康社会决定因素的策略，以避免该人群使用潜在的可预防的 ED。

People with kidney failure receiving maintenance dialysis visit the emergency department (ED) 3 times per year on average, which is 3- to 8-fold more often than the general population. Little is known about the factors that contribute to potentially preventable ED use in this population.To identify the clinical and sociodemographic factors associated with potentially preventable ED use among patients receiving maintenance dialysis.This cohort study used linked administrative health data within the Alberta Kidney Disease Network to identify adults aged 18 years or older receiving maintenance dialysis (ie, hemodialysis or peritoneal dialysis) between April 1, 2010, and March 31, 2019. Patients who had been receiving dialysis for more than 90 days were followed up from cohort entry (defined as dialysis start date plus 90 days) until death, outmigration from the province, receipt of a kidney transplant, or end of study follow-up. The Andersen behavioral model of health services was used as a conceptual framework to identify variables related to health care need, predisposing factors, and enabling factors. Data were analyzed in March 2024.Rates of all-cause ED encounters and potentially preventable ED use associated with 4 kidney disease-specific ambulatory care-sensitive conditions (hyperkalemia, heart failure, volume overload, and malignant hypertension) were calculated. Multivariable negative binomial regression models were used to examine the association between clinical and sociodemographic factors and rates of potentially preventable ED use.The cohort included 4925 adults (mean [SD] age, 60.8 [15.5] years; 3071 males [62.4%]) with kidney failure receiving maintenance hemodialysis (3183 patients) or peritoneal dialysis (1742 patients) who were followed up for a mean (SD) of 2.5 (2.0) years. In all, 3877 patients had 34 029 all-cause ED encounters (3100 [95% CI, 2996-3206] encounters per 1000 person-years). Of these, 755 patients (19.5%) had 1351 potentially preventable ED encounters (114 [95% CI, 105-124] encounters per 1000 person-years). Compared with patients with a nonpreventable ED encounter, patients with a potentially preventable ED encounter were more likely to be in the lowest income quintile (38.8% vs 30.9%; P < .001); to experience heart failure (46.8% vs 39.9%; P = .001), depression (36.6% vs 32.5%; P = .03), and chronic pain (60.1% vs 54.9%; P = .01); and to have a longer duration of dialysis (3.6 vs 2.6 years; P < .001). In multivariable regression analyses, potentially preventable ED use was higher for younger adults (incidence rate ratio [IRR], 1.69 [95% CI, 1.33-2.15] for those aged 18 to 44 years) and patients with chronic pain (IRR, 1.35 [95% CI, 1.14-1.61]), greater material deprivation (IRR, 1.57 [95% CI, 1.16-2.12]), a history of hyperkalemia (IRR, 1.31 [95% CI, 1.09-1.58]), and historically high ED use (ie, ≥3 ED encounters in the prior year; IRR, 1.46 [95% CI, 1.23-1.73).In this study of adults receiving maintenance dialysis in Alberta, Canada, among those with ED use, 1 in 5 had a potentially preventable ED encounter; reasons for such encounters were associated with both psychosocial and medical factors. The findings underscore the need for strategies that address social determinants of health to avert potentially preventable ED use in this population.