Hospital-based inpatient resource utilization associated with autosomal dominant polycystic kidney disease in the US

Abstract

Objective:

Polycystic kidney disease (PKD) is a clinically and genetically heterogeneous class of genetic disorders characterized by development of renal cysts leading to renal failure and end stage renal disease (ESRD). Autosomal dominant polycystic kidney disease (ADPKD) accounts for the majority of PKD cases and is the predominant monogenic cause of ESRD. Limited information on patient characteristics and healthcare resource utilization is available in this population. This study assessed hospital-based inpatient utilization of patients with ADPKD in the US to help further understand the disease, which may lead to treatments that delay progression and reduce healthcare resource utilization.

Methods:

A cross-sectional analysis was conducted using MedAssets Health System Data to investigate inpatient resource utilization for a total of 1876 patients hospitalized with ADPKD or chronic kidney disease (CKD). Patient characteristics and inpatient resource utilization were compared between hospitalized patients with ADPKD and CKD, including demographic and clinical characteristics, overall health, rates of complications and surgical interventions, and average length of hospital and intensive care unit stay.

Results:

Compared with patients with CKD, patients with ADPKD were more likely to have commercial insurance as their primary payer (36.1 vs 17.8%) and were significantly younger (mean age 57.9 vs 69.5 years) and generally healthier (Charlson Comorbidity Score of 2.0 vs 3.3). Patients with ADPKD also had a substantially shorter average length of hospital stay (6.3 vs 10.3 days). However, patients with ADPKD experienced more kidney-related complications and a higher surgical procedure rate (mainly for transplant and complete nephrectomy).

Conclusions:

Although patients with ADPKD were generally healthier than patients with CKD, specific kidney function complications were more frequent. Patients with ADPKD had a higher rate of major kidney procedures, which may contribute to the high burden of ADPKD-related hospital-based inpatient resource utilization.

Keywords::

• Autosomal dominant polycystic kidney disease
• Inpatient resource utilization
• Healthcare
• Chronic kidney disease
• Disease progression

Transparency

Declaration of funding

This study was sponsored by Otsuka America Pharmaceutical, Inc., Princeton, NJ. Medical writing and editorial support for the preparation of this manuscript was provided by Scientific Connexions, Inc., Lyndhurst, NJ, funded by Otsuka America Pharmaceutical, Inc.

Declaration of financial/other relationships

CB & BG were employees of Otsuka America Pharmaceutical, Inc. at the time this study was conducted. SR is a current employee of Otsuka America Pharmaceutical, Inc. CC & KB are employees of MedAssets, Inc., which has received funds from Otsuka America Pharmaceutical, Inc. in connection with the conduct of this study. DL is an employee of Outcomes Insights, Inc., which has received funds from Otsuka America Pharmaceutical, Inc. in connection with the conduct of this study. JME peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors would like to acknowledge Scientific Connexions, Inc., for assistance in the preparation of this manuscript for submission.