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Abstract: TH-PO1003

Identifying CKD Stage 3 with Excess Disease Burden

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Crittenden, Stanley D., Evergreen Nephrology, Nashville, Tennessee, United States
  • Chu, Lihao, Rubicon Founders, Nashville, Tennessee, United States

Chronic kidney disease (CKD) is a widely prevalent disease with heterogeneous disease progression. Current practice guidelines recommend nephrology referral when patients are diagnosed with CKD stage 4. Prior studies suggest earlier referral to nephrologists can improve health outcomes for patients with chronic kidney disease (CKD), however claims-based methods to identify high-risk CKD stage 3 patients remain lacking. We assessed cost, utilization, and disease progression in patients with various stages of CKD, including an identified subset of patients with CKD stage 3 and common medical comorbidities.


This is a retrospective study of Medicare fee-for-service beneficiaries with CKD stages 3-5. We identified seven comorbidities with high prevalence in patients with progressive CKD and segmented beneficiaries with CKD stage 3 based on the presence of these comorbidities. Outcomes including costs, utilization, and disease progression were then compared across beneficiaries with different stages of CKD.


We identified that beneficiaries with CKD stage 3 and at least one of the selected comorbidities (CKD stage 3-plus), represented 35.4% of all beneficiaries with CKD stage 3. The CKD stage 3-plus cohort had cost and utilization patterns that were more similar to beneficiaries with CKD stages 4 and 5 compared to beneficiaries with CKD stage 3 without the selected comorbidities.


Our findings demonstrate the use of a claims-based algorithm to identify patients with CKD stage 3 that are high cost and at risk of disease progression, highlighting a potential subset of patients who might benefit from earlier nephrology intervention.