Temporal trends in healthcare resource use and costs of chronic kidney disease in a Spanish population: the REDIC study.

OBJECTIVES

This study aimed to assess 10-year trends in healthcare resource utilization (HCRU) and associated direct and indirect costs related to chronic kidney disease (CKD) from both a societal and payer (CatSalut) perspectives in Catalonia, Spain.

METHODS

Retrospective, population-based cohort study including 447,202 newly diagnosed CKD cases from the SIDIAP database between 2012 and 2022. HCRU and costs were analyzed annually using a bottom-up, prevalence-based approach and reported per 1,000 patient-years. Data sources included primary care (PC), hospital admissions, and national cost databases.

RESULTS

Over the 10-year study period, drug treatments and outpatient visits consistently accounted for the largest share of HCRU. Between 2014 and 2021, total CKD-related costs rose from €3.66 million to €4.61 million, representing a 26% increase. Hospitalizations consistently accounted for over 50% of total costs, with CKD-specific hospitalization costs increasing notably after 2017. Visit-related costs were the second-largest expenditure, declining from 25.2% of total costs in 2014 to 18.2% in 2021, with PC visits remaining the dominant outpatient category. Expenditures related to kidney replacement therapy increased substantially, rising from €144,188 in 2014 to €370,111 in 2021, a 157% rise, primarily driven by dialysis. Indirect costs associated with sick leave nearly doubled, rising from €324,770 in 2014 to €680,672 in 2021, representing a 110% increase.

CONCLUSIONS

CKD-related hospitalizations were a significant cost driver in Catalonia. Enhancing early detection, reinforcing PC capacity, and optimizing outpatient management could help reduce costly hospital dependence and address the rising clinical and economic burden of CKD in regional health systems.