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Abstract: PO1972

Prevalence and Progression of Pediatric CKD in a Large National Cohort

Session Information

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology

Authors

  • Modi, Zubin J., University of Michigan, Ann Arbor, Michigan, United States
  • Troost, Jonathan P., University of Michigan, Ann Arbor, Michigan, United States
  • Dombkowski, Kevin J., University of Michigan, Ann Arbor, Michigan, United States
  • Gipson, Debbie S., University of Michigan, Ann Arbor, Michigan, United States
Background

National prevalence and disease progression for pre-ESKD chronic kidney disease in children (pCKD) are not well described.

Methods

Data for children <19 years of age were extracted from the IBM MarketScan commercial and Medicaid databases for the years 2009-2018. pCKD prevalence estimates were calculated using stage-specific ICD-CM diagnosis codes (585 and N18) and additional established qualifying pCKD codes. Survival curves were created to estimate the probability of reaching ESKD, stratified by type of CKD code utilized (stage-specific vs other codes).

Results

We identified children <19 years with commercial insurance (n=42,051,432) and Medicaid (n=13,610,450) over the 10-year period. Among these children, we found 197,318 with pCKD among those with commercial insurance (47 per 10,000) and 101,361 among those with Medicaid (74 per 10,000). pCKD stage-specific diagnoses were infrequently reported (commercial insurance:12%; Medicaid: 14%). Among the children with pCKD, 30% with commercial and 35% with Medicaid had multiple years of follow-up. Survival curves over the 10-year study period showed the majority of the progression to ESKD was among those with stage-specific pCKD (Figure).

Conclusion

In a large national cohort, 298,679 children with pCKD were identified over 10 years, with higher period prevalence in Medicaid-insured children. Stage-specific information was available for a small proportion of children, but when present was associated with a higher probability of reaching ESKD. This data suggests that children with conventional, staged CKD codes are more likely to have rapid progression while other codes that qualify for pCKD may capture children with kidney disease that are slower to progress.

Probability of Kidney Survival Stratified by Type of Diagnostic Code

Funding

  • Other NIH Support