Predicting Costs Of Care In Chronic Kidney Disease: The Role Of Comorbid Conditions

We examined the relationship between cost of care, CKD and comorbidities (proteinuria, coronary artery disease, congestive heart failure (CHF), diabetes mellitus, hypertension, anemia, and hyperlipidemia. Cases were adults with two estimated GFR <90ml/min/1.72m as follows; 60-89 (GFR 2); 30-59 (GFR 3); and 15-29 (GFR 4). Controls were matched on age and gender. Subjects were followed for up to 66 months and costs were annualized and weighted by months of observation. Linear regression was used to predict costs as a function of disease category, controlling for comorbidities. We found that total costs over the follow-up period for those with CKD were almost $5,000 higher than controls for GFR 4, and almost $2,600 higher in GFR 2 and 3. Anemia and congestive heart failure independently raised total costs by almost $5,700, but the effect of anemia is greatest at earlier stages of CKD. Work on this paper was done at the Center for Health Research Kaiser Permanente, Northwest, Portland Oregon. The source of support was received from Amgen