Abstract: PO0553
Burden of Secondary Hyperparathyroidism: A Matched Comparison Using Administrative Claims Data from Germany
Session Information
- Bone and Mineral Metabolism: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Csomor, Philipp, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
- Schneider, Kim Maren, Xcenda GmbH, Hannover, Niedersachsen, Germany
- Stremel, Timotheus, Xcenda GmbH, Hannover, Niedersachsen, Germany
- Kaiser, Edelgard, Vifor Pharma Ltd, Glattbrugg, Zurich, Switzerland
- Meise, Dominic, Xcenda GmbH, Hannover, Niedersachsen, Germany
Background
Secondary hyperparathyroidism (SHPT) is a frequent, early, and progressive complication in chronic kidney disease (CKD) characterized by excessive parathyroid hormone production. SHPT independently predicts serious complications like cardiovascular diseases (CVD), fractures, progression to dialysis, and death. Analysis of data on the burden of CKD patients with SHPT in the German health insurance system is lacking.
Methods
A German health insurance claims database comprising data from 2014-2018 served as a source to identify CKD stage 3 and 4 patients, who were stratified by the occurrence of incident SHPT using ICD-10-GM diagnosis and ATC prescription codes. SHPT patients were matched 1:1 to non-SHPT patients in the same CKD stage using propensity scores. Index date was the first SHPT diagnosis quarter in the SHPT cohorts, and a randomly chosen quarter of a CKD diagnosis within the CKD-only cohorts. Patients with evidence of dialysis or kidney transplant prior to the index quarter were excluded. Matched groups were compared with respect to the prevalence of CVD (acute and recurrent myocardial infarction (MI), chronic ischemic heart disease, congestive heart failure (HF), and atherosclerosis (ATH)), dialysis, and CKD progression in a two-year follow-up period.
Results
Overall, 1,156 incident SHPT patients in CKD3 and 517 in CKD4 and their respective matches were identified. Prevalence of combined CVD conditions was higher in SHPT patients (46.8% vs. 41.9% p<0.05 in CKD3, 56.5% vs. 51.8% p=0.13 in CKD4). HF was more frequent among SHPT patients (34.6% vs. 28.6% p<0.01 in CKD3 and 46.4% vs. 39.3% in CKD4 p<0.05) while acute MI was observed significantly more often among CKD4 patients in the SHPT cohort (9.1% vs. 5.8% p<0.05). ATH was more frequent in SHPT patients in CKD4 (18.6% vs. 14.3% p=0.06). SHPT patients progressed to CKD5 more often (6.1% vs. 1.2% from CKD3, 26.7% vs. 2.9% from CKD4, both p<0.01) which resulted in a higher proportion of dialysis (6.1% vs. 1.3% in CKD3, 22.1% vs. 3.7% in CKD4, both p<0.01).
Conclusion
Patients with CKD3&4 and incident SHPT presented with a significantly higher disease progression to CKD5 and dialysis and had a higher prevalence of CVD compared to patients without SHPT during a two-year follow-up period.
Funding
- Commercial Support –