OBJECTIVES: Every third of the adults with diabetes in the United States (US) have chronic kidney disease (CKD). However, little is known about the relationships between CKD and mental and physical health in this population. Therefore, the aims of this study are: [1] to evaluate the relationships between CKD and mental and physical health measures; and [2] to estimate the difference in the likelihood of polypharmacy, inpatient services and emergency department use between adults with CKD and without CKD.

METHODS: : A cross-sectional study design was implemented utilizing data from multiple panels (2009-2015) of the Medical Expenditure Panel Survey.

RESULTS: The study sample comprised 8,406 adults with diabetes, and 969 of them (11.24%) reported that diabetes has led to CKD. The results show that as age increases, the percentage of CKD also increases. Adults in the age group of 65 or more had significantly highest percentage of CKD (12.76%). Similarly, significantly higher proportion of adults who were economically poor had CKD (15.02%) than their counterparts with higher income. Further, CKD was more prevalent among adults with public insurance than those with private insurance (15.39% vs 8.90%). In the adjusted analyses, adults with CKD had significantly lower mental component summary scores and physical component summary scores (β=-2.88, p<0.001 and β=-5.69, p<0.001 respectively) compared to those without CKD. Furthermore, adults with CKD were more likely to have serious psychological distress (AOR= 1.53; p<0.001), practice polypharmacy (AOR=2.09; p<0.001), and were more likely to use inpatient (AOR=1.87; p<0.001) and emergency department services (AOR= 1.72; p<0.001).

CONCLUSIONS: The present study found that CKD is associated with poor health, and with higher likelihood of using polypharmacy, inpatient and emergency department services. Prevention programs and initiatives are needed to minimize the risk for CKD among adults with diabetes to prevent CKD related complications.