OBJECTIVES: Chronic kidney disease, overweight and obesity are growing public health challenges in the U.S. with large financial implications. To examine healthcare utilization and expenditures among end-stage renal disease population by body mass index. METHODS: This was a retrospective cross-sectional study of 225 U.S. adults with end-stage renal disease. The Medical Expenditure Panel Survey, a representative sample of the U.S. households was utilized. End-stage renal disease cases with clinical classification codex value of 158 were pooled for calendar cyears 2002 to 2011. Self-reported body mass index was classified as underweight (BMI < 18.5), normal weight (18.50 < BMI < 24.99), overweight (25 < BMI < 29.99) and obese (BMI > 30). Mean annual health care use and expenditures were estimated by body mass index among end-stage renal disease adults. RESULTS: