ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: TH-PO355

REVOLUTIONIZE III: Consequences of Recurrent Hyperkalemia on Healthcare Resource Utilization and Cost

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

  • Bakris, George L., Department of Medicine, University of Chicago, Chicago, Illinois, United States
  • Agiro, Abiy, US Evidence, US Medical Affairs, AstraZeneca, Wilmington, Delaware, United States
  • Greatsinger, Alexandra, Analysis Group, New York, New York, United States
  • Sundar, Manasvi, Analysis Group, Los Angeles, California, United States
  • Guo, Helen, Analysis Group, Los Angeles, California, United States
  • Louden, Elaine Maria, Analysis Group, Boston, Massachusetts, United States
  • Cook, Erin, Analysis Group, Boston, Massachusetts, United States
  • Colman, Ellen, US Renal, US Medical Affairs, AstraZeneca, Wilmington, Delaware, United States
  • Mu, Fan, Analysis Group, Boston, Massachusetts, United States
  • Desai, Pooja N., US Renal, US Medical Affairs, AstraZeneca, Wilmington, Delaware, United States
Background

Hyperkalemia (HK) is associated with increased healthcare resource utilization (HRU) and costs, but there are limited data on the impact of HK recurrence on these in patients (pts) with chronic kidney disease (CKD). This real-world study describes all-cause medical costs and HRU in pts with recurrent HK (rHK), non-recurrent HK (nrHK) and normokalemia (NK).

Methods

Pts aged ≥18 years with stage 3/4 CKD were identified from Optum’s de-identified Market Clarity data; HK was classified as rHK or nrHK by a claims-based algorithm. Pts with rHK were 1:1 exact and propensity-score matched with separate cohorts of pts with NK and nrHK. Index dates were the date of the first event of the index pair of HK diagnosis with ≥1 serum K+ value >5.0 mEq within 7 days (rHK and nrHK cohorts) or a randomly-selected serum K+ lab value of 3.5–5.0 mmol/L (NK cohort). Continuous insurance was required for 12 months before and after the index date. Study outcomes were all-cause medical costs and HRU over 12 months.

Results

There were 4549 matched pairs in the rHK vs NK analysis and 1599 matched pairs in the rHK vs nrHK analysis. The rHK cohorts had significantly higher mean per-pt all-cause medical costs than the NK cohort ($34,163 vs $15,175) and nrHK cohort ($52,290 vs $38,233) over 12 months (Table); HRU rates were also significantly higher for the rHK cohorts. The increased costs were driven by increased inpatient medical costs with rHK vs NK and rHK vs nrHK.

Conclusion

Large increases in all-cause medical costs and HRU after HK recurrence illustrate the unmet need for chronic management of HK in pts with stage 3/4 CKD, such as through long-term novel potassium binder therapies.

All-cause medical costs and HRU in patients with stage 3/4 CKD with or without HK

Funding

  • Commercial Support – AstraZeneca