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首页> 外文OA文献 >Prevalence, treatment patterns, and healthcare resource utilization in Medicare and commercially insured non-dialysis-dependent chronic kidney disease patients with and without anemia in the United States
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Prevalence, treatment patterns, and healthcare resource utilization in Medicare and commercially insured non-dialysis-dependent chronic kidney disease patients with and without anemia in the United States

机译：医疗保险的患病率，治疗模式和医疗资源利用和商业上保险的非透析依赖性慢性肾病患者和美国没有贫血的患者

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Abstract Background Anemia is common in non-dialysis-dependent chronic kidney disease (NDD-CKD) patients, but detailed information on prevalence and treatment is lacking. Methods We evaluated anemia prevalence and treatment using two datasets: the Medicare 20% random sample (ages 66–85 years), and the Truven Health MarketScan database (ages 18–63 years). We selected stage 3–5 NDD-CKD patients with and without anemia from both databases during 2011–2013. We evaluated anemia prevalence and treatment (erythropoietin stimulating agents [ESAs], intravenous [IV] iron, red blood cell [RBC] transfusions) following anemia diagnosis during a 1-year baseline period, and healthcare utilization during a 1-year follow-up period. We used Poisson regression models to compare healthcare utilization in patients with and without anemia, adjusting for demographics, baseline comorbid conditions, inflammatory conditions, and CKD stage. Results We identified 218,079 older and 56,188 younger stage 3–5 NDD-CKD patients. Anemia prevalence increased with age in both datasets; was higher in women, black patients (Medicare only), and patients with comorbid conditions; and rose sharply with increasing CKD stage. Of 15,716 younger anemic patients, 11.7%, 10.8%, and 9.4% were treated with RBC transfusion, ESAs, and IV iron, respectively. Corresponding proportions of 109,251 older anemic patients were 22.2%, 12.7%, and 6.7%. Regardless of age, anemic patients were more likely than non-anemic patients to use healthcare resources, including hospitalizations and emergency department, hematologist, nephrologist, and outpatient visits. Anemic NDD-CKD patients were more likely to be treated with RBC transfusion than with ESAs or IV iron. Conclusion More research is necessary to determine best approaches to anemia management in CKD.
机译：摘要背景贫血在非透析依赖性慢性肾病（NDD-CKD）患者中是常见的，但缺乏关于患病率和治疗的详细信息。方法评估使用两个数据集的贫血患病率和治疗：Medicare 20％随机样品（66-85岁），以及Truven Health Marketscan数据库（18-63岁）。我们在2011-2013期间选择了患有3-5阶段的患有和不含贫血的患者。我们评估了贫血患病率和治疗（促红细胞生成素刺激剂[esas]，静脉内[IV]铁，红细胞，红细胞[RBC]输血在1年的基线期间诊断后，以及在1年的后续行动期间的医疗利用率时期。我们使用Poisson回归模型来比较患有贫血患者的医疗保健利用，调整人口统计，基线合并条件，炎症条件和CKD阶段。结果我们确定了218,079岁及56,188阶段的3-5名NDD-CKD患者。贫血患病率随着两个数据集的年龄而增加;女性，黑人患者（仅限医疗保险）和患有合并症的病症;随着CKD阶段的增加，并升高。血糖患者的15,716名，11.7％，10.8％和9.4％分别用RBC输血，ESA和IV铁处理。相应比例为109,251名血糖患者的22.2％，12.7％和6.7％。无论年龄段，贫血患者比非贫血患者更有可能使用医疗资源，包括住院和急诊部，血液学家，肾病专家和门诊观察。贫血NDD-CKD患者更容易用RBC输血治疗，而不是与ESAS或IV铁进行处理。结论更多的研究是确定CKD中贫血管理的最佳方法。

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