Kidney Week

Abstract: SA-PO0398

Severe Kidney Events, CKD Hospitalizations, and Health Care Costs in Patients with CKD and Heart Failure in the Multinational CaRe Study

Session Information

• CKM: Clinical - Epidemiology and Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Pecoits-Filho, Roberto, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Roberto Pecoits-Filho, MD, PhD, FASN

• Anderson, Lisa J., City St George’s, University of London, London, United Kingdom

Lisa J. Anderson, MD

• Savarese, Gianluigi, Karolinska Institutet, Stockholm, Stockholm County, Sweden

Gianluigi Savarese

• Kondo, Toru, Nagoya Daigaku Daigakuin Igakukei Kenkyuka Igakubu, Nagoya, Aichi Prefecture, Japan

Toru Kondo, MD, PhD

• Adamsson Eryd, Samuel, AstraZeneca, Gothenburg, Sweden

Samuel Adamsson Eryd, PhD

• Bodegard, Johan, RWE Research, Oslo, Norway

Johan Bodegard, MD, PhD

• Mullin, Katrina, AstraZeneca, Cambridge, United Kingdom

Katrina Mullin, PhD

• Rikner, Klas, AstraZeneca, Gothenburg, Sweden

Klas Rikner, PhD

• Thuresson, Marcus, Statisticon, Uppsala, Sweden

Marcus Thuresson, PhD

• Enxing, Joshua, AstraZeneca, Cambridge, United Kingdom

Joshua Enxing, MS, MSc

• Greene, Stephen, Duke University Duke Clinical Research Institute, Durham, North Carolina, United States

Stephen Greene, MD

Background

Severe kidney events, such as end-stage renal disease (ESRD) and renal replacement therapy, are costly but relatively infrequent, so may not fully capture the burden of disease. Comorbid chronic kidney disease (CKD) and heart failure (HF) are associated with higher risks of adverse outcomes. We describe the incidence and associated costs of severe kidney events and CKD-related hospitalizations in patients with CKD and HF.

Methods

This observational cohort study included 2 752 649 patients with CKD only, HF only or CKD+HF from databases in England, Japan, Sweden and the USA (index date January 1, 2022). Patients with prior eGFR < 15 mL/min/1.73 m², dialysis or kidney transplant were excluded. Outcomes included severe kidney events (ESRD, dialysis, transplant), CKD-related hospitalizations and associated hospital healthcare costs within 1 year of index.

Results

Patients with CKD+HF were older, had more advanced renal dysfunction and had a higher burden of cardiovascular comorbidities than CKD- or HF-only groups. Across countries, CKD+HF was associated with the highest risks and costs for both incident severe kidney events and CKD-related hospitalizations (1.3–3.9-fold higher than CKD only; 3.3–30.0-fold higher than HF only; Figure). The main drivers of severe kidney event costs were ESRD (63.0–88.3% across countries) and dialysis (20.1–76.9%); CKD-related hospitalizations captured a broader, more consistent economic burden across countries.

Conclusion

Across countries, comorbid CKD+HF was associated with higher risks of kidney disease progression and hospitalization, and greater costs, than CKD or HF only. While ESRD and dialysis were the main drivers of severe kidney event costs, with substantial variation between healthcare systems, CKD-related hospitalizations captured a more consistent economic burden.

Funding

• Commercial Support – AstraZeneca