Comparison of healthcare utilization between patients with stage 3–5 CKD and patients with normal-eGFR: an observational study of west region of France

This study aims to compare healthcare utilization between patients with stage 3–5 chronic kidney disease (CKD) and patients with normal estimated glomerular filtration rate (n-eGFR) to identify differences in healthcare needs. This retrospective observational study included patients hospitalized in Western France between 2015 and 2018. CKD was defined by an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 measured at least 90 days apart or a recorded CKD diagnosis without eGFR > 90 mL/min/1.73 m 2 , corresponding to KDIGO stages 3–5. Patients with n-eGFR had eGFR consistently ≥ 90 mL/min/1.73 m 2 without any acute kidney injury episode. Clinical hospital data were then linked to the French National Health Data System (SNDS) to determine 2015 healthcare utilization, categorized into inpatient (nephrology-related and -unrelated hospitalizations) and outpatient care (consultations with general practitioners, nephrologists, cardiologists, endocrinologists). Overall, 26,125 stage 3–5 CKD and 292,559 patients with n-eGFR were included. Hospitalization duration increased with age and CKD severity. Nephrology-related hospitalizations declined with age, while unrelated ones rose, especially among patients with stage 5 CKD aged > 85 years (~ 1,800 per 1,000 person-years). General practitioners’ consultation rates increased with age and CKD stage, peaking at 9,000 per 1,000 person-years in > 85-year-olds with stage 5 CKD. Nephrologist consultations were most frequent in younger stage 5 CKD patients and decreased with age. Stage 3–5 CKD and age strongly affect healthcare utilization, underscoring the need for tailored care and better coordination, especially in older patients and advanced CKD.