Moderate kidney disease costs medicare tens of billions of dollars each year

(Press-News.org) Washington, DC (August 1, 2013) — Even early stages of kidney disease come with steep medical costs, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). The study found that expenses related to moderate chronic kidney disease (CKD) cost Medicare tens of billions of dollars each year.

Approximately 60 million people globally have CKD. Most of the costs of CKD are thought to arise when the disease progresses to kidney failure, also known as stage 5 CKD. The Centers for Disease Control and Prevention funded investigators from RTI International to study whether people who had early stages of CKD also incurred considerable medical costs that could be attributed to their disease.

"It was difficult to answer this question, because early stages of CKD often go undiagnosed. However, by using a sample of participants from the National Health and Nutrition Examination Survey III, or NHANES III, we were able to obtain lab measurements and estimate stages of CKD for persons in the sample," explained first author Amanda Honeycutt, PhD. The researchers then received permission to have Medicare payment data merged with the NHANES III data to determine the impact of diseases and other factors on Medicare spending. The lab data used in the analyses were from 1988 through 1994, and they were linked to Medicare costs for 1991 through 1994.

Among the major findings: Medicare spending attributable to CKD stages 2 through 4 is likely to exceed $48 billion per year. Medicare costs attributable to stage 2 CKD amounted to $1700 per person per year. Costs attributable to stage 3 CKD were $3500 per person per year, and for stage 4 CKD they were $12,700 per person per year, adjusted to 2010 dollars.

"This study is important because we were able to identify that even early stages of CKD—before people progress to full end-stage renal disease—contribute to high Medicare costs," said Dr. Honeycutt. The findings suggest that efforts to prevent the development of CKD may lead to significant savings. In addition, the study highlights the need to identify CKD in its earliest stages to prevent disease progression and avoid the high medical costs attributable to the latter stages of the disease.

### Study co-authors include Joel E. Segel, BA, Xiaohui Zhuo, PhD, Thomas Hoerger, PhD, Kumiko Imai, PhD, and Desmond Williams, MD PhD.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Medical Costs of Chronic Kidney Disease in the Medicare Population," will appear online at http://jasn.asnjournals.org/ on August 1, 2013, doi: 10.1681/ASN.2012040392.

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Founded in 1966, and with more than 14,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.