title: Impact of Renal Disease on Patients with Hepatitis C: A Retrospective Analysis of Disease Burden, Clinical Outcomes, and Health Care Utilization and Cost.
abstract: OBJECTIVE
  Few studies explore the magnitude of the disease burden and health care utilization imposed by renal disease among patients with hepatitis C virus (HCV). We aimed to describe the characteristics, outcomes, and health care utilization and costs of patients with HCV with and without renal impairment.
  
  
  METHODS
  This retrospective analysis used 2 administrative claims databases: the US commercially insured population in Truven Health MarketScan® data (aged 20-64 years), and the US Medicare fee-for-service population in the Medicare 20% sample (aged ≥65 years). Baseline characteristics and comorbid conditions were identified from claims during 2011; patients were followed for up to 1 year (beginning January 1, 2012) to identify health outcomes of interest and health care utilization and costs.
  
  
  RESULTS
  In the MarketScan and Medicare databases, 35,965 and 10,608 patients with HCV were identified, 8.5 and 26.5% with evidence of renal disease (chronic kidney disease [CKD] or end-stage renal disease [ESRD]). Most comorbid conditions and unadjusted outcome rates increased across groups from patients with no evidence of renal disease to non-ESRD CKD to ESRD. Health care utilization followed a similar pattern, as did the costs.
  
  
  CONCLUSIONS
  Our findings suggest that HCV patients with concurrent renal disease have significantly more comorbidity, a higher likelihood of negative health outcomes, and higher health care utilization and costs.
authors.affiliation: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN, USA.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Solid
authors.forename: Senaka A
authors.initials: SA
authors.lastname: Peter
authors.forename: Tanya
authors.initials: T
authors.lastname: Natwick
authors.forename: Haifeng
authors.initials: H
authors.lastname: Guo
authors.forename: Allan J
authors.initials: AJ
authors.lastname: Collins
authors.forename: Jean Marie
authors.initials: JM
authors.lastname: Arduino
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D017281:Cost of Illness; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006526:Hepatitis C / Q000150:complications* / Q000191:economics / Q000628:therapy*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000191:economics / Q000628:therapy*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D006278:Medicare; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
keywords: Chronic kidney disease; End-stage renal disease; Health care utilization; Hepatitis C virus; Outcomes