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Clinical Epidemiology
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Medical Costs of CKD in the Medicare Population

Amanda A. Honeycutt, Joel E. Segel, Xiaohui Zhuo, Thomas J. Hoerger, Kumiko Imai and Desmond Williams
JASN September 2013, 24 (9) 1478-1483; DOI: https://doi.org/10.1681/ASN.2012040392
Amanda A. Honeycutt
*Research Triangle International, Research Triangle Park, North Carolina;
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Joel E. Segel
†University of Michigan, School of Public Health, Ann Arbor, Michigan;
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Xiaohui Zhuo
‡Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
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Thomas J. Hoerger
*Research Triangle International, Research Triangle Park, North Carolina;
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Kumiko Imai
§Atlanta, Georgia
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Desmond Williams
‡Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
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    Table 1.

    Summary statistics for overall sample population by stage of CKD

    Parameter DescriptionOverallNo CKDCKD Stage 1CKD Stage 2CKD Stage 3CKD Stage 4
    Patients (n)4148a253916143893856
    Patients (%)10045.3 ± 1.62.6 ± 0.39.1 ± 0.621.0 ± 1.11.1 ± 0.2
    Age (yr)72.0 ± 0.370.4 ± 0.369.0 ± 1.573.8 ± 0.876.4 ± 0.577.2 ± 1.4
    Women (%)55.9 ± 1.052.9 ± 1.344.7 ± 5.456.5 ± 3.366.6 ± 2.258.8 ± 9.8
    Race/ethnicity (%)
     White85.2 ± 1.186.1 ± 1.264.9 ± 6.179.3 ± 2.488.0 ± 1.480.1 ± 7.3
     Hispanic/Latino2.2 ± 0.22.2 ± 0.25.2 ± 1.03.0 ± 0.41.3 ± 0.21.5 ± 0.8
     Black8.6 ± 1.17.9 ± 1.225.5 ± 6.310.9 ± 2.47.0 ± 1.410.2 ± 7.8
    Diabetes13.0 ± 0.68.8 ± 0.726.4 ± 5.925.6 ± 2.918.5 ± 1.823.0 ± 7.2
    Hypertension64.6 ± 1.056.5 ± 1.175.1 ± 5.578.6 ± 2.481.0 ± 1.894.6 ± 3.4
    Myocardial infarction11.9 ± 1.09.7 ± 1.115.1 ± 3.912.9 ± 2.417.2 ± 1.824.3 ± 8.0
    Stroke6.3 ± 0.54.7 ± 0.66.5 ± 2.27.7 ± 1.510.3 ± 1.414.7 ± 6.6
    Congestive heart failure7.6 ± 0.65.1 ± 0.75.9 ± 2.49.1 ± 1.614.2 ± 1.423.1 ± 9.0
    Cancer20.6 ± 1.119.1 ± 1.215.7 ± 3.725.1 ± 3.124.1 ± 2.118.8 ± 6.8
    Asthma8.4 ± 0.59.2 ± 0.814.3 ± 5.07.6 ± 2.05.6 ± 1.16.5 ± 3.4
    Arthritis45.1 ± 1.243.4 ± 1.434.7 ± 6.944.5 ± 3.451.3 ± 2.458.8 ± 8.3
    Pneumonia2.9 ± 0.42.8 ± 0.44.0 ± 3.52.4 ± 0.93.5 ± 0.70.5 ± 0.5
    Back pain24.0 ± 0.923.3 ± 1.024.8 ± 4.825.1 ± 2.825.0 ± 2.233.6 ± 6.9
    Chronic bronchitis9.4 ± 0.68.9 ± 0.99.5 ± 4.88.9 ± 1.710.9 ± 1.59.6 ± 5.3
    Total medical costs (2010$)b7200 ± 2706100 ± 3709200 ± 17907900 ± 9009300 ± 65018,600 ± 4520
    • Unless otherwise noted, values are expressed as mean ± SEM.

    • ↵a Includes 16 people who had ESRD.

    • ↵b Updated to 2010 dollars by using the medical care component of the Consumer Price Index, rounded to the nearest $100.

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    Table 2.

    Per person and total costs attributable to CKD

    CKD StagePer Person Costs (95% CI)aEstimated Medicare FFS Enrollees, 2008 (n)bTotal CKD Costs for Medicare FFS Enrollees ($)c
    11600 (−900 to 3870)474,0120.76 billion
    21700 (530 to 2840)2,700,4324.56 billion
    33500 (1780 to 4620)10,726,31737.18 billion
    412,700 (6000 to 19,650)563,7877.17 billion
    • Updated to 2010 dollars by using the medical care component of the Consumer Price Index. Each part of the two-part cost models estimated also included controls for age, age-squared, sex, race/ethnicity, education, region of residence, and each of the following comorbid conditions: diabetes, hypertension, cancer, arthritis, pneumonia, back pain, chronic bronchitis, and asthma. CI, confidence interval.

    • ↵a Bootstrapped 95% CIs by using 1000 iterations.

    • ↵b Calculated by using estimates of CKD prevalence for the population age 65 years or older to most closely approximate the Medicare population; prevalence estimated by using 1999–2004 NHANES data applied to 2010 Medicare enrollment data.

    • ↵c Estimates are the product of the per person cost point estimates and the number of enrollees.

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Journal of the American Society of Nephrology: 24 (9)
Journal of the American Society of Nephrology
Vol. 24, Issue 9
September 2013
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Medical Costs of CKD in the Medicare Population
Amanda A. Honeycutt, Joel E. Segel, Xiaohui Zhuo, Thomas J. Hoerger, Kumiko Imai, Desmond Williams
JASN Sep 2013, 24 (9) 1478-1483; DOI: 10.1681/ASN.2012040392

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Medical Costs of CKD in the Medicare Population
Amanda A. Honeycutt, Joel E. Segel, Xiaohui Zhuo, Thomas J. Hoerger, Kumiko Imai, Desmond Williams
JASN Sep 2013, 24 (9) 1478-1483; DOI: 10.1681/ASN.2012040392
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  • Longitudinal TNFR1 and TNFR2 and Kidney Outcomes: Results from AASK and VA NEPHRON-D
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