OBJECTIVES:

To evaluate healthcare resource use in haemodialysis (HD) patients with and without chronic kidney disease associated pruritis (CKD-aP).

METHODS:

Patients were selected from the Clinical Practice Research Datalink GOLD and Aurum datasets linked to Hospital Episode Statistics (HES). A ‘case’ was defined as a HD patient with CKD-aP, the index date being the date of first recorded diagnosis of pruritus following initiation of dialysis. Cases were propensity score matched to HD patients without pruritis (controls), whose index date was assigned as the number of days following dialysis initiation of their respective case. All patients had received chronic haemodialysis (≥ 90 days of dialysis with <90 days break between records). Healthcare contacts and associated costs (UK 2019/2020 prices) were calculated per person year (PPY) and generalised linear models were constructed to compare contacts (Poisson) and costs (Gamma).

RESULTS:

5,296 patients were included in the analysis (n=2,648, cases and controls). The mean age was 66 years and 61% were male. Costs PPY were significantly greater for cases than controls for general practice (GP) (cases: £473; controls: £307, IRR[CI]: 1.57[1.44-1.70]), inpatient (£22,883; £21,685; 1.09[1.01-1.19]), outpatient (£1,973; £1,661; 1.14[1.06-1.23]), emergency department (£317; £253; 1.18[1.06-1.33]) and primary-care prescriptions (£2,152; £1,773; 1.37[1.25-1.51]). Contact with health care services was significantly greater in cases for GP (17.6; 11.3; 1.53[1.50-1.55]), inpatient (126.2; 121.8; 1.03[1.03-1.04]), outpatient (17.9; 15.0; 1.19[1.17-1.21]), emergency department (1.9; 1.5; 1.24[1.18-1.31]) and primary-care prescriptions (155.8; 109.3; 1.40[1.40-1.41]). Cases also had a greater number of admissions associated with dialysis (122.3; 117.6; 1.04[1.03-1.04]) and associated costs (£19,135; £17,640; 1.10[1.02-1.19]).

CONCLUSIONS:

CKD associated pruritis is associated with both higher costs and increased health care utilisation in the haemodialysis population. The higher inpatient resource use is driven by a greater number of admissions associated with dialysis in patients with pruritus. More detailed analyses will be presented.