Chronic Kidney Disease and US Healthcare Resource Utilization in a Nationally Representative Sample

Abstract

Background: Chronic kidney disease (CKD) is a prevalent condition; however, little is known about healthcare resource utilization (HRU) by CKD patients. Methods: This analysis included NHANES participants aged ≥18 years, with serum creatinine, urine protein, and hemoglobin measurements. We assessed the association between CKD (stratified by stage) and HRU based on self-reported physician visits and hospitalizations in the year preceding the survey. Results: Of the 15,258 included in this analysis, 2,110 had early CKD (stage 1 and 2 CKD) and 1,121 had late CKD (stage 3 and 4 CKD). Mean (SE) number of annual physician visits were 3.51 (0.08), 4.43 (0.18), and 6.53 (0.38) for participants with no CKD, early CKD, and late CKD, respectively. Mean (SE) number of annual hospitalizations were 0.15 (0.01), 0.19 (0.01), and 0.42 (0.03) for participants with no CKD, early CKD, and late CKD, respectively. Participants with late CKD were more likely to have more physician visits (OR 1.81, 95% CI 1.46, 2.23) and have more hospital admissions (OR 2.12, 95% CI 1.66, 2.71) compared with participants with early CKD or no CKD. Conclusions: In this analysis, late stage CKD was associated with increased HRU, suggesting the need for early identification and treatment of CKD and its associated conditions.

Effect of Chronic Kidney Disease and Comorbid Conditions on Health Care Costs: A 10-Year Observational Study in a General Population

“…The finding that costs were substantially increased among those with CKD, even after controlling for important comorbid conditions, suggests that CKD independently adds significant economic burden. In addition, our study indicates that several comorbid conditions modified the services use associated with CKD, which is in line with another population-based study [6]. …”

“…The costs distribution suggests that interventions slowing the progression of CKD and reducing the rate of transitions to ESRD can potentially achieve savings through avoiding the costs likely to incur at later disease stages [6]. In addition, measures to avoid CKD-related comorbidities might also generate substantial cost savings.…”

“…In addition, it is increasingly apparent that individuals with CKD are more likely to develop cardiovascular disease [3,5]. Thus, apart from direct costs of treating patients with CKD, the higher risk for developing CKD-related conditions is expected to produce markedly increased expenses [6,7]. Although the economic consequences of CKD and prevention of progression to more severe disease stages are important for health system planners and public health agencies, they have not been well studied.…”

Access to Health Care Among Adults Evaluated for CKD: Findings From the Kidney Early Evaluation Program (KEEP)

“…In addition, complications of CKD, such as anemia or secondary hyperparathyroidism, may require more frequent involvement with a nephrologist alone or in conjunction with a generalist. 12 Hispanic and African American participants were less likely than whites to have seen a physician within the last year and more likely to report difficulty obtaining medical care at all CKD stages. Although cultural beliefs and area racial composition may explain some of these discrepancies, 13 differences in insurance coverage and overall education status also likely have a substantial role.…”

Aberrations in Renal Function Parameters Following Oral Administration of <i>Phyllanthus amarus</i> in Cadmium-Induced Kidney Damage in Adult Wistar Rats

“…Renal disease has been found to be the ninth leading cause of death [1] and renal failure is one of the most common clinical symptoms [2]. Renal failure refers to decline of excretory functions of kidney and it is usually characterized by decrease in glomerular filtration rate (GFR) which results in the abnormal retention of blood urea and serum creatinine which must be excreted [3].…”