Objectives: To describe healthcare costs among CKD patients with and without T2D by CKD stage.

Methods: CKD patients with/without T2D in 2018 were identified from the HealthCore Integrated Research Database using claims linked to lab results and census block group level social determinants of health information. Patients were assigned to the CKD-only group if ≥2 claims for CKD and no claim for type 1 diabetes or T2D any time prior to index and the CKD-in-T2D group if ≥2 claims with an ICD-10 diagnosis code denoting both conditions or a combination of the individual codes for T2D and CKD. IndexDate was first claim date with diagnosis of CKD/T2D. Patients were required to have ≥1 year of pre- and post-index enrollment and ≥1 serum creatinine result with no evidence of dialysis, cancer, or pregnancy. CKD eGFR staging was based on the Kidney Disease Improving Global Outcomes (KDIGO) 2012 guideline and healthcare costs were analyzed descriptively.

Results: Among 8,721 CKD-only and 14,677 CKD-in-T2D patients, the percentage by CKD stage was: stage1 (14% vs 20%), stage2 (35% vs 33%), stage3a (29% vs 25%), stage3b (17% both), stage4 (5% both), and stage5 (0.4% both), respectively. The proportion of Black race was similar between groups in stages 1-4 (13-19%) and stage5 (20-22%). Both groups lived in areas with ~87% with high school degree/equivalent or higher and 13-17% of poverty rate across stages. All-cause healthcare costs in CKD- vs CKD-in-T2D only: stage1 ($33,420 vs $30,544), stage2 ($23,253 vs $37,115), stage3a ($20,615 vs $32,072), stage3b ($21,515 vs $33,152), stage4 ($32,179 vs $41,285) and stage5 ($94,917 vs $90,358), respectively.

Conclusions: Annual costs were substantial for all patients with CKD in this commercial/MA population. CKD-in-T2D was associated with higher costs in KDIGO CKD stages 2-4 than in those with CKD-only, with costs considerably higher in stage5 for all CKD patients.