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Kidney Week

Abstract: FR-PO880

IgA Nephropathy and Impact of Proteinuria Level and CKD Stage on Health Care Resource Utilization in Germany

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Schaufler, Thilo, CSL Vifor, Glattbrugg, Switzerland
  • Ramirez de Arellano, Antonio, CSL Vifor, Glattbrugg, Switzerland
  • Dasgupta, Sonali, IQVIA Inc, Wayne, Pennsylvania, United States
Background

Proteinuria ≥1.0 g/day is a risk factor for immunoglobulin A nephropathy (IgAN) progression. This study describes the impact of proteinuria level and chronic kidney disease (CKD) stage on healthcare resource utilization (HRU) and costs among patients with IgAN in Germany.

Methods

Eligible patients had ≥1 ICD-9 583.9, ICD-10 N02.8, or ICD-10 N02.9 code between 2015 and 2022. CKD stage was defined by ICD-10 N18 code and estimated glomerular filtration rate. Patients were divided into two subgroups based on proteinuria: <1 g/day and ≥1 g/day. Average HRU costs for in-patient and out-patient visits were calculated based on German Diagnosis-Related Groups Statistic 2022 and published literature. Owing to data unavailability in the German database, emergency visit counts were extrapolated using German base rates updated with costing ratios and patient count ratios from the UK and Spain.

Results

We identified 1,600 patients with IgAN (mean age 58 years, 67% male). For all visit types combined, the mean total cost per patient was >14-fold higher for CKD stage 5 than stage 1 (€57,977 vs €4,046). Mean total cost per patient was >2.5-fold higher with proteinuria ≥1 g/day than with <1 g/day (€5,530 vs €2,154) (Figure 1). Out-patient visits were low compared with other markets and likely underreported. For in-patient and out-patient visits, HRU increased with advancing CKD and higher proteinuria level (Figure 2).

Conclusion

In patients with IgAN in Germany, advanced CKD stage and elevated proteinuria were associated with higher HRU and costs. Treatments that reduce proteinuria can slow disease progression and prevent rapid kidney function decline while potentially reducing IgAN-related HRU and associated costs.

Funding

  • Commercial Support – CSL Vifor