Healthcare resource utilization and costs of chronic kidney disease in Spain across KDIGO categories: Insights from real-world evidence

Abstract

Aim: To determine the healthcare resource utilization and costs in patients with chronic kidney disease (CKD) across the KDIGO stages in real-world clinical practice in Spain. Methods: Observational, retrospective study using the BIG-PAC database. Adults with >= 1 measurement of estimated glomerular filtration rate (eGFR) and albuminuria closest to 1st January 2018 were included. Annual healthcare resource utilization and healthcare costs per patient were analyzed within a two-year follow-up period. Results: 70,385 subjects were included, of whom 30.0% had CKD. The proportion of patients with >= 1 hospitalization ranged from 12.0% to 52.9% in categories G3a to G5 A1, from 6.0% to 47.4% in categories G1 to G5 A2 and from 13.5% to 69.8% in categories G1 to G5 A3. First year mean (SD) total cost ranged from 2486.65 (1724.25) to 16,085.75 (11,731.67), 1567.67 (1293.56) to 14,647.70 (11,031.45) and 2799.43 (1800.53) to 20,584.74 (11,563.63) Euros, respectively. Overall, the main driver for total cost was hospitalizations. All these numbers increased as eGFR declined or albuminuria increased and, in general, there was a slight decrease during the second year in all categories. Conclusions: In real-world, CKD may be associated with high healthcare resource utilization and costs that increase as renal function worsens or albuminuria levels increase. Reducing economic burden through primordial and primary prevention policies, and comprehensive management with kidney protective drugs should be a priority.