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Abstract: FR-PO958

Economic Burden of CKD in the United States: A Systematic Literature Review

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials


  • Chatterjee, Satabdi, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
  • Rochon, Hannah, Broadstreet HEOR, Vancouver, British Columbia, Canada
  • Osenenko, Katherine M., Broadstreet HEOR, Vancouver, British Columbia, Canada
  • Donato, Bonnie M.k., Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States

With nearly 37 million cases of CKD in the US, the economic impact is substantial. To fully understand the economic burden of CKD to payers and health systems, as well as drivers of burden, a comprehensive assessment of the recent evidence base is needed. This review aimed to characterize direct medical costs of those diagnosed with CKD in the US, overall and by CKD stage, insurance type, and presence of diabetes mellitus (DM), cardiovascular disease (CVD), and obesity.


A systematic literature review was conducted using MEDLINE and Embase, supplemented by a grey literature search, to identify studies reporting direct medical costs for CKD in the US, published between 01/01/2017 and 07/27/2022. Conference proceedings from 2020 to 2022 that were identified in the search were also considered for inclusion. Two reviewers independently performed study selection and data extraction according to PRISMA guidelines. Patient characteristics and cost estimates were summarized; mean annual cost estimates were converted to 2022 USD and reported.


From 3,424 abstracts, 52 citations representing 39 distinct studies were included. Sample sizes ranged from 52 to 7,091,324; mean age ranged from 45 to 79 years and the percentage of males from 33% to 98%. Direct medical costs ranged from $6,592 to $280,727 per patient. In studies of CKD-only patients reporting costs by stage (n=3), costs ranged from $6,592 (stage 3) to $143,745 (end stage kidney disease [ESKD]). Of studies evaluating comorbidities (n=14), patients with DM had costs as high as $280,727 (new onset ESKD & DM), while those with CVD had costs as high as $70,742 (CKD & heart failure). No studies investigated costs among those with comorbid obesity. In studies reporting components of medical costs for CKD-only (n=7), inpatient costs tended to be the largest component ranging from $2,331 to $116,309. No trend was observed in costs by payer type.


The review found that direct medical costs among patients with CKD continues to be high, primarily driven by inpatient costs. Other contributory factors included advanced CKD stages and presence of cardiometabolic comorbidities.


  • Commercial Support – This study was funded by Boehringer Ingelheim.