title: Chronic kidney disease and US healthcare resource utilization in a nationally representative sample.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a prevalent condition; however, little is known about healthcare resource utilization (HRU) by CKD patients.
  
  
  METHODS
  This analysis included NHANES participants aged > or =18 years, with serum creatinine, urine protein, and hemoglobin measurements. We assessed the association between CKD (stratified by stage) and HRU based on self-reported physician visits and hospitalizations in the year preceding the survey.
  
  
  RESULTS
  Of the 15,258 included in this analysis, 2,110 had early CKD (stage 1 and 2 CKD) and 1,121 had late CKD (stage 3 and 4 CKD). Mean (SE) number of annual physician visits were 3.51 (0.08), 4.43 (0.18), and 6.53 (0.38) for participants with no CKD, early CKD, and late CKD, respectively. Mean (SE) number of annual hospitalizations were 0.15 (0.01), 0.19 (0.01), and 0.42 (0.03) for participants with no CKD, early CKD, and late CKD, respectively. Participants with late CKD were more likely to have more physician visits (OR 1.81, 95% CI 1.46, 2.23) and have more hospital admissions (OR 2.12, 95% CI 1.66, 2.71) compared with participants with early CKD or no CKD.
  
  
  CONCLUSIONS
  In this analysis, late stage CKD was associated with increased HRU, suggesting the need for early identification and treatment of CKD and its associated conditions.
authors.affiliation: Harvard University and Beth Israel Deaconess Medical Center, 1737 Cambridge Street, Cambridge, MA 02138, USA. malexand@fas.harvard.edu
authors.forename: Marcus
authors.initials: M
authors.lastname: Alexander
authors.forename: Brian D
authors.initials: BD
authors.lastname: Bradbury
authors.forename: Reshma
authors.initials: R
authors.lastname: Kewalramani
authors.forename: Arie
authors.initials: A
authors.lastname: Barlev
authors.forename: Sarita A
authors.initials: SA
authors.lastname: Mohanty
authors.forename: Denise
authors.initials: D
authors.lastname: Globe
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009819:Office Visits / Q000706:statistics & numerical data; D051436:Renal Insufficiency, Chronic / Q000191:economics / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology