Association of secondary hyperparathyroidism with CKD progression, health care costs and survival in diabetic predialysis CKD patients.
Nephron Clin Pract
; 113(1): c54-61, 2009.
Article
in En
| MEDLINE
| ID: mdl-19590235
ABSTRACT
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.
Full text:
1
Database:
MEDLINE
Main subject:
Health Care Costs
/
Diabetic Nephropathies
/
Health Resources
/
Hyperparathyroidism, Secondary
Type of study:
Etiology_studies
/
Health_economic_evaluation
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Language:
En
Journal:
Nephron Clin Pract
Year:
2009
Type:
Article
Affiliation country:
United States