Tag: Kidney disease

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Early-Stage Chronic Kidney Disease Linked to Significant Health Care Spending Increase Over 5 Years, Study Finds

Cohort study of nearly 80,000 participants reveals the economic impact of early-stage CKD on health care utilization.

A new study conducted in Japan involving 79,988 participants sheds light on the substantial health care spending associated with early-stage chronic kidney disease (CKD). The research, utilizing nationwide health checkup and medical claims data, indicates a strong correlation between mild reductions in estimated glomerular filtration rates (eGFR), proteinuria, and health care spending over a 5-year period.

Key Findings:

  1. Excess Health Care Spending: The study, conducted from April 2021 to October 2023, reveals that early-stage CKD is linked to greater excess health care spending. Participants with mildly reduced eGFR, proteinuria, or a combination of both consistently exhibited higher health care spending over the examined 5-year period.
  2. Association Beyond Traditional Risk Factors: Even after adjusting for common risk factors such as hypertension and diabetes, mild reductions in eGFR and the presence of proteinuria were independently associated with excess health care spending.
  3. Longitudinal Impact: The research not only assessed the cross-sectional impact but also examined the longitudinal effects over 5 years. The findings suggest a constant need for excess health care spending in individuals with early-stage CKD, with the combination of proteinuria and mildly reduced eGFR showing an increasing trend over time.
  4. Preventive Measures Urged: The study concludes by emphasizing the importance of designing actions to prevent the occurrence and progression of CKD. It suggests that interventions aimed at reducing the economic burden associated with early-stage CKD are crucial for sustaining a healthcare system.

Background:

Chronic kidney disease affects a significant portion of the global population and is a known risk factor for end-stage kidney disease and cardiovascular disease. The study emphasizes that while advanced-stage CKD has been linked to higher health care utilization, evidence regarding the economic burden of early-stage CKD has been limited.

Implications:

The study’s findings highlight the need for targeted interventions and preventive measures to address early-stage CKD, considering its impact on health care spending. Identifying and addressing CKD-related practices could help reduce excess health care utilization and contribute to a more sustainable healthcare system.

Note: The information presented is based on the provided study results and abstract.

Credit: JAMA Network Open, Naomi Sakoi

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Study Reveals Disparities in Access to Kidney Transplant and Nephrology Care Among Patients with Pregnancy-Related End-Stage Kidney Disease

Introduction: A comprehensive cohort study involving 183,640 reproductive-aged women sheds light on the long-term outcomes of patients with pregnancy-related end-stage kidney disease (ESKD). The research uncovers significant racial disparities, emphasizing the urgent need for improved postpartum care.

Key Findings:

  1. Disproportionate Representation: Black patients constitute 31.9% of those with pregnancy-related ESKD, in contrast to 16.2% in the general birthing population.
  2. Survival Rates: Patients with pregnancy-related ESKD exhibit equivalent or better survival rates compared to those with other causes of ESKD, challenging conventional assumptions.
  3. Transplant Disparities: Despite comparable or superior survival rates, patients with pregnancy-related ESKD face significantly reduced access to kidney transplants. Notably, they are less likely to join the transplant waiting list or receive live donor transplants.
  4. Nephrology Care: Patients with pregnancy-related ESKD are significantly less likely to have access to nephrology care before ESKD onset, underlining potential gaps in early intervention and care planning.
  5. Pre-ESKD Care: Access to nephrology care or placement of a graft or arteriovenous fistula before ESKD onset is substantially lower in patients with pregnancy-related ESKD compared to other causes, highlighting disparities in pre-dialysis care.

Implications: The study suggests that the existing disparities in access to kidney transplant and nephrology care may exacerbate the health outcomes of a disproportionately Black population. The findings underscore the need for targeted interventions to improve access to comprehensive care and reduce the racial disparities observed.

Conclusion: While patients with pregnancy-related ESKD demonstrate promising long-term survival rates, the study calls attention to critical gaps in access to kidney transplant and nephrology care, particularly affecting the Black population. Addressing these disparities is crucial to enhancing the quality of life and overall health outcomes for this vulnerable demographic. The study’s authors advocate for prioritized efforts to improve postpartum care and reduce racial inequalities in maternal health.

Note: This summary is a concise representation of the study’s key points and implications. For more detailed information, readers are encouraged to refer to the complete study.

Credit: JAMA Network Open, Lauren M. Kucirka