BACKGROUND/AIMS: The objective of this study was to examine health care costs and utilization and the risks of dialysis or mortality among diabetic predialysis chronic kidney disease (CKD) patients with and without secondary hyperparathyroidism (SHPT). METHODS: This retrospective, matched cohort study examined insurance claims from 703 adult diabetic predialysis CKD patients with and without SHPT during a 72-month follow-up period. Annualized estimates of health care service utilization, costs and disease progression to dialysis or death following index CKD diagnosis were compared. RESULTS: Preindex (baseline) characteristics were similar between the cohorts. Postindex numbers of prescription utilization, outpatient service utilization and hospitalizations were all higher (p < 0.0001) in diabetic CKD patients with SHPT compared to those without SPHT in both unadjusted and adjusted analyses even after multivariate adjustment for known confounders. The rate of progression to dialysis or death was higher for diabetic CKD patients with SHPT compared to those without SPHT. Those with SHPT were at higher risk of requiring dialysis treatment [hazard ratio (HR) = 6.7; 95% confidence interval (CI) = 4.3-10.6] and death (HR = 2.3; 95% CI = 1.1-4.9) compared to those without SHPT. CONCLUSION: In diabetic predialysis CKD patients, the presence of SHPT is associated with significantly greater health care resource utilization and costs, and a faster rate of disease progression.
BACKGROUND/AIMS: The objective of this study was to examine health care costs and utilization and the risks of dialysis or mortality among diabetic predialysis chronic kidney disease (CKD) patients with and without secondary hyperparathyroidism (SHPT). METHODS: This retrospective, matched cohort study examined insurance claims from 703 adult diabetic predialysis CKDpatients with and without SHPT during a 72-month follow-up period. Annualized estimates of health care service utilization, costs and disease progression to dialysis or death following index CKD diagnosis were compared. RESULTS: Preindex (baseline) characteristics were similar between the cohorts. Postindex numbers of prescription utilization, outpatient service utilization and hospitalizations were all higher (p < 0.0001) in diabetic CKDpatients with SHPT compared to those without SPHT in both unadjusted and adjusted analyses even after multivariate adjustment for known confounders. The rate of progression to dialysis or death was higher for diabetic CKDpatients with SHPT compared to those without SPHT. Those with SHPT were at higher risk of requiring dialysis treatment [hazard ratio (HR) = 6.7; 95% confidence interval (CI) = 4.3-10.6] and death (HR = 2.3; 95% CI = 1.1-4.9) compared to those without SHPT. CONCLUSION: In diabetic predialysis CKDpatients, the presence of SHPT is associated with significantly greater health care resource utilization and costs, and a faster rate of disease progression.
Authors: Charu Gupta; Glenn M Chertow; Mark T Linthicum; Karen Van Nuys; Vasily Belozeroff; Darryl Quarles; Darius N Lakdawalla Journal: Health Serv Res Date: 2014-07-07 Impact factor: 3.402
Authors: Georges Saab; Andrew S Bomback; Samy I McFarlane; Suying Li; Shu-Cheng Chen; Peter A McCullough; Adam Whaley-Connell Journal: J Clin Endocrinol Metab Date: 2012-10-12 Impact factor: 5.958
Authors: Andrea Galassi; Antonio Bellasi; Sara Auricchio; Sergio Papagni; Mario Cozzolino Journal: Biomed Res Int Date: 2013-08-07 Impact factor: 3.411
Authors: Evan W Davies; Louis S Matza; Gavin Worth; David H Feeny; Jacqueline Kostelec; Steven Soroka; David Mendelssohn; Philip McFarlane; Vasily Belozeroff Journal: Health Qual Life Outcomes Date: 2015-06-30 Impact factor: 3.186