Abstract: TH-PO448
Diagnosis and Management of Polycystic Kidney Disease in a Commercially Insured Population
Session Information
- Cystic Kidney Diseases: Clinical Assessment and Therapeutic Directions
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Genetic Diseases of the Kidneys
- 1201 Genetic Diseases of the Kidneys: Cystic
Authors
- Han, Yun, University of Michigan, Ann Arbor, Michigan, United States
- Heung, Michael, University of Michigan, Ann Arbor, Michigan, United States
- Jawed, Areeba, University of Michigan, Ann Arbor, Michigan, United States
- Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
- Xu, Fang, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
- Miyamoto, Yoshihisa, Centers for Disease Control and Prevention, Atlanta, Georgia, United States
- Garimella, Pranav S., University of California San Diego, La Jolla, California, United States
- Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
Background
Since the approval of vasopressin V2-receptor antagonist tolvaptan to treat polycystic kidney disease (PKD) in April 2018, there has been an increase in diagnosis of PKD. Generally reserved for younger patients with aggressive disease, tolvaptan is associated with increased healthcare costs in managing PKD. We sought to investigate contemporary diagnostic and management practices among commercially insured patients with newly diagnosed PKD.
Methods
Patients with PKD were identified in Optum Clinformatics™ Data (2016-2020, 38.7 million beneficiaries) by ICD-10 diagnosis codes. A one-year look-back window was utilized to identify newly diagnosed PKD, determined by the initial diagnosis codes on or after January 1, 2017. CPT codes were used to identify kidney imaging: ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT); brain vascular imaging: magnetic resonance angiography (MRA) and computed tomography angiography (CTA); genetic testing; kidney related surgery; and tolvaptan. Utilization of these services were analyzed one year prior to and two years following the PKD diagnosis, except for surgery and tolvaptan (post-diagnosis only).
Results
A total of 15,260 newly diagnosed PKD patients were identified (mean age: 57.9 years). Service utilization included nephrologist visit (59.3%), kidney MRI (10.2%), CT (43.3%), brain MRA or CTA (12.6%), ultrasound (40.9%), genetic consultation (3.4%), kidney-related surgery (0.6%), and tolvaptan (2.2%).
Conclusion
PKD-related health service utilization varied with low use of advanced imaging procedure among a large commercially insured population. Findings may underscore the need for standardized care protocols and enhanced awareness of PKD management strategies to improve disease outcomes.
Funding
- Other U.S. Government Support