Hospital-based inpatient resource utilization associated with autosomal dominant polycystic kidney disease in the US.
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.
['Blanchette|Christopher M|CM|', 'Craver|Christopher|C|', 'Belk|Kathy W|KW|', 'Lubeck|Deborah P|DP|', 'Rossetti|Sandro|S|', 'Gutierrez|Benjamin|B|']
D000293:Adolescent D000328:Adult D017677:Age Distribution D000368:Aged D000369:Aged, 80 and over D015897:Comorbidity D003365:Costs and Cost Analysis D003430:Cross-Sectional Studies D018450:Disease Progression D005260:Female D006295:Health Resources D006760:Hospitalization D006801:Humans D007297:Inpatients D007348:Insurance, Health D007676:Kidney Failure, Chronic D008297:Male D008875:Middle Aged D010351:Patient Discharge D016891:Polycystic Kidney, Autosomal Dominant D012044:Regression Analysis D051436:Renal Insufficiency, Chronic D014481:United States D055815:Young Adult
Inpatient resource utilization Autosomal dominant polycystic kidney disease Healthcare Chronic kidney disease Disease progression