Program

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In-person registration included the full virtual experience, and virtual-only attendees will be able to tune into live in-person sessions and/or watch captured in-person sessions on-demand in addition to having a variety of virtual-only sessions to attend.

Inpatient Healthcare Resource Use Outcomes Among Patients Living with Chronic Kidney Disease and Anemia in the United States

Speaker(s)

Belk K, Clark LA, Banuelos RC, Rizzo E
Lumen Value & Access, New York City, NY, USA

OBJECTIVES: Anemia is a complication of chronic kidney disease (CKD) associated with Black race, comorbid diabetes, and advancing disease. The objective of this study was to perform a cross-sectional analysis of real-world data comparing inpatient resource use among patients with CKD and anemia (CKD-A) and without anemia (CKD-NA).

METHODS: Adults in the Healthcare Cost and Utilization Project National Inpatient Sample (NIS) (2016-2019) were included. CKD-A (n=711,151) and CKD-NA (n=2,518,886) groups were compared for mortality, length of stay (LOS) and cost-to-charge-ratio adjusted charges (costs). Mortality comparisons used Chi-square tests and Hospital NIS-weighted logistic regression. General linear models with negative binomial and gamma distributions were used for LOS and costs, respectively. All models controlled for hospital and patient characteristics.

RESULTS: Whites represented 61.4% of hospitalizations. CKD-A patients were more likely to be Black (29.2% vs 18.5%) or Hispanic (14.3% vs 8.2%) and more likely to have end-stage renal disease (ESRD) (59.4% vs 16.2%, p<.0001) compared with CKD-NA patients. ESRD was more prevalent in Blacks (40.9%) and Hispanics (44.2%) than Whites (16.7%). Common comorbidities included congestive heart failure (CKD-A=51.5%, CKD-NA=48.8%) and diabetes with complications (CKD-A=57.2%, CKD-NA=46.0%). Top complications in CKD-A included metabolic acidosis (18.0% vs 12.1%), secondary hyperparathyroidism of renal origin (19.9% vs 3.4%), phosphorus metabolism disorders (10.3% vs 3.1%), and hyperkalemia (24.6% vs 12.6%). Unadjusted mortality was lower in CKD-A (3.1% vs 4.1%, p<.0001). After controlling for other factors, anemia was associated with lower mortality (OR=0.57, p<.0001). Multivariable analyses revealed anemia was associated with longer LOS (IRR=1.054 [CI=1.051-1.056). Median cost (IQR) was higher in the CKD-A population ($11,094 [$6,490–$20,102]) compared to CKD-NA ($9,686 [$5,749-$17,484]). Anemia was associated with lower costs in multivariable analyses (IRR=0.971 [CI=0.969-0.974]. CKD Stage was the primary driver of mortality, LOS and costs.

CONCLUSIONS: Anemia was associated with longer LOS but lower mortality rates and costs in CKD.

Code

CO111

Topic

Clinical Outcomes

Topic Subcategory

Clinical Outcomes Assessment

Disease

No Additional Disease & Conditions/Specialized Treatment Areas