Researchers found hospitalizations accounted for the majority of the cost increase in the time frame immediately before patients begin dialysis. The findings surprised researchers because fully insured Medicare patients who receive adequate care should have a smoother--and thus less expensive--transition to dialysis, says Wendy St. Peter, an associate professor at the University of Minnesota College of Pharmacy and lead author on the study. The findings are reported in the July 2004 issue of the journal, Kidney International.

"We believe that optimal management of chronic kidney disease patients may not only extend the time before dialysis is necessary, but it will also reduce future health care expenses, particularly around the start of dialysis," St. Peter says. "Medicare and other health care payers need to understand how expensive it is to care for chronic kidney disease patients who later go on dialysis. Third-party payers also need to understand the importance of identifying and treating patients as soon as possible. This, we hope, will reduce the high costs associated with dialysis."

Estimates put the number of U.S. adults with chronic kidney disease at around 20 million. Medicare claims for patients with end-stage renal disease (the final stage of chronic kidney disease, when dialysis is needed) total more than $16 billion annually. This amount is spent on a relatively small number of patients (about 300,000).

Researchers looked at Medicare claims from 109,321 patients who received care for chronic kidney disease from 1995 to 1998. They looked at the costs associated with caring for chronic kidney disease patients during the two years before they began dialysis and
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Contact: Sharon Agsalda
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1-Sep-2004