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Abstract: SA-PO431

Economic Burden of Hyperkalemia in the Medicare System

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular


  • Betts, Keith, Analysis Group, Inc., Boston, Massachusetts, United States
  • Woolley, J. Michael, ZS Pharma Inc., San Mateo, California, United States
  • Mu, Fan, Analysis Group, Inc., Boston, Massachusetts, United States
  • Xiang, Cheryl Q., Analysis Group, Inc., Boston, Massachusetts, United States
  • Dua, Akanksha, Analysis Group, Inc., Boston, Massachusetts, United States
  • Wu, Eric, Analysis Group, Inc., Boston, Massachusetts, United States

The objective of this study was to estimate the economic burden associated with hyperkalemia in the Medicare population.


Adult patients with and without hyperkalemia (cases vs. controls), were selected from the Medicare Claims Database (5% random sample) (1/1/2010-12/31/2014). Hyperkalemia was defined as having at least one diagnosis code of hyperkalemia (ICD-9-CM 276.7). The index date was a randomly selected claim date with hyperkalemia diagnosis for cases and a randomly selected claim date for controls. Continuous enrollment for at least 6 months before the index date (baseline period) and 12 months after the index date (study period) was required. Controls were exactly matched one-to-one to cases on age group, chronic kidney disease (CKD) stage, dialysis and heart failure (HF). 30-day and 1-year resource utilization and total costs (2016 USD) were compared between cases and controls.


A total of 90,814 patients with hyperkalemia were matched to 90,814 patients without hyperkalemia. Cases had higher rates of inpatient admissions (30-day: 0.48 vs. 0.06; 1 year: 1.28 vs. 0.44), outpatient visits (30-day: 3.11 vs. 3.04; 1-year: 30.48 vs. 23.88), emergency department (ED) visits (30-day: 0.27 vs. 0.14; 1-year: 2.01 vs. 1.17) and skilled nursing facility (NF) admissions (30-day: 0.15 vs. 0.02; 1-year: 0.36 vs. 0.11) (all p<0.001). Cases also had more inpatient days (30-day: 3.79 vs. 0.34; 1-year: 10.54 vs. 3.04) and skilled NF days (30-day: 2.46 vs. 0.39; 1-year: 14.78 vs. 4.84) compared to controls (all p<0.001). Cases incurred $7,208 higher 30-day costs ($8,894 vs. $1,685) and $19,348 higher 1-year costs ($34,362 vs. $15,013) than controls (both p<0.001). Among the 41,271 matched pairs of patients with CKD and/or HF, the 30-day and 1-year total cost differences were $7,726 ($9,906 vs. $2,180) and $21,577 ($41,416 vs. $19,839), respectively (both p<0.001).


Patients with hyperkalemia were more likely to have inpatient, ED and skilled NF admissions, and had longer stays in inpatient and skilled NF compared to their matched patients without hyperkalemia. These data indicate that hyperkalemia is associated with a significant economic burden to Medicare.