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

Alexander M.a · Bradbury B.D.b · Kewalramani R.c · Barlev A.d · Mohanty S.A.e · Globe D.d
aHarvard University and Beth Israel Deaconess Medical Center, Boston, Mass., bDepartment of Biostatistics and Epidemiology, Amgen Inc., cClinical Development, Amgen Inc., dGlobal Health Economics, Amgen Inc., Thousand Oaks, Calif., and eUniversity of Southern California, Keck School of Medicine, Los Angeles, Calif., USA Am J Nephrol 2009;29:473–482 (DOI:10.1159/000178816)


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.


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