Non-technique-related healthcare utilization and costs among dialysis and kidney transplant recipients in Spain: a real-world analysis.

BACKGROUND

Kidney failure requiring kidney replacement therapy (KRT) is associated with a substantial and growing economic burden. While the costs directly attributable to KRT modalities are well documented, the resource use and costs unrelated to KRT modalities remain unclear.

OBJECTIVE

To quantify healthcare resource utilization (HCRU) and costs in patients receiving dialysis or kidney transplantation, excluding technique-related costs.

METHODS

This retrospective observational study used BIG-PAC real-world data to analyze dialysis or kidney transplant patients as of January 1, 2018, with a two-year follow-up. Patients were identified based on related diagnostic or procedure codes recorded in electronic health records (EHRs) prior to the index date. Major adverse cardiovascular events (MACE), hospitalization for CKD and mortality were evaluated. HCRU, direct healthcare costs, and indirect productivity costs due to sick leave were assessed, excluding technique-related KRT costs.

RESULTS

Of 70,973 individuals, 356 (0.5%) were on dialysis and 232 (0.3%) had kidney transplantation. Over two years, MACE per 1000 patient-years were 276.3 for dialysis and 85.9 for transplantation. CKD hospitalization rates were 245.7 and 183.0, with mortality rates of 253.8 and 35.6, respectively. First-year health costs averaged €25,410.4 (SD €17,369.0) for dialysis patients and €4,472.8 (SD €2,859.1) for transplant recipients. Most costs among dialysis and kidney transplant patients were driven by hospitalization, 72.4% and 39.8%, respectively. Indirect costs due to sick leave were also substantial.

CONCLUSION

Non-technique-related costs represent a substantial component of the overall economic burden in patients receiving KRT, largely driven by hospitalizations. These findings provide important context for healthcare planning, although they do not represent total costs of care and should be interpreted as descriptive estimates.