*Purpose: The 30-day readmission rate is a surrogate metric of quality of care and mortality after kidney transplantation. Diabetes and observations of glucose variability during hospitalization are independent risk factors for 30-day readmission among the general population. This has not been studied after kidney transplantation.

*Methods: We conducted a retrospective study analyzing the 30-day readmission rate among kidney transplant recipients transplanted at a single center between 07/01/2015 and 12/31/2018. The aim of the study was to determine if the following were associated with hospital readmission within 30 days after kidney transplantation: (1) diabetes mellitus prior to transplantation (2) variability in glucose measurements during hospitalization after kidney transplantation.

*Results: Our cohort consists of 1036 patients undergoing kidney transplant. 437 (42.2%) had diabetes prior to transplant. The median hospital stay after kidney transplant was 3 days. 224 (21.6%) patients had readmissions within 30 days. The patients with diabetes prior to transplant had higher readmission rates (28.4% vs 16.7% among non-diabetics, p < 0.001). The presence of hypoglycemia and hyperglycemia were associated with higher readmission rates as noted in Table 1.Table 1: Association with 30-day readmission and extremes in glucose variability

*Average value (standard deviation) for continuous variables and the relative incidence rate for binary risk factors **Relative Risk (RR) is the ratio of the probability of 30-day readmission for the exposed group to the probability of 30-day readmission for the unexposed patient sample. *** Relative frequency of blood glucose measurements that are above 180 for a given patient during the admission (percent of the blood glucose measurement values are above 180 mg/dL **** Presence of hyperglycemia: Indicates whether the patient had at least one measurement above 180 mg/dL

*Conclusions: Our findings highlight the importance of the following risk factors for 30-day readmission: 1. Presence of diabetes prior to kidney transplantation. 2. Presence of hypoglycemia and hyperglycemia after kidney transplantation. This analysis suggests that better blood glucose management after kidney transplantation, a modifiable factor, could result in reducing the incidence of 30-day readmission.

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