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Kidney Week

Abstract: SA-PO651

Burden of Illness of Primary Hyperoxaluria with CKD

Session Information

Category: Genetic Diseases of the Kidneys

  • 1202 Genetic Diseases of the Kidneys: Non-Cystic

Authors

  • Goldfarb, David S., NYU Langone Health, New York, New York, United States
  • Chen, Jing Voon, Genesis Research LLC, Hoboken, New Jersey, United States
  • Li, Olivia, Trinity Partners LLC, Waltham, Massachusetts, United States
  • Skaar, Jeffrey R., Trinity Partners LLC, Waltham, Massachusetts, United States
  • Salem, Sandra, Novo Nordisk Inc, Plainsboro, New Jersey, United States
  • Modersitzki, Frank, NYU Langone Health, New York, New York, United States
Background

Primary hyperoxaluria (PH) is a rare genetic disorder characterized by the overproduction of oxalate, which combines with calcium to form calcium oxalate crystals, leading to kidney stones, CKD, and kidney failure. The burden of illness for people with PH and CKD (PH-CKD) relative to people with CKD alone (non-PH-CKD) is unclear. This study aims to understand epidemiology, patient characteristics, treatment, healthcare resource utilization, and cost of care of people with PH who have normal or impaired kidney function.

Methods

This retrospective, non-interventional, observational study uses real-world US administrative data from the 2017-2021 Merative MarketScan® Commercial Claims and Encounters databases and the 2017-2021 CMS Medicare Fee-For-Service Limited Data Set. The study includes people with PH (at least 1 medical claim with PH diagnosis in 2020-2021 and no secondary hyperoxaluria or Crohn’s disease), PH-CKD (PH criteria and at least 1 medical claim with CKD diagnosis in 2017-2021), and non-PH-CKD (no PH or secondary PH diagnosis in 2017-2021 and CKD criteria).

Results

There were ~4,500 people with diagnosed PH in US in 2021; 37% presented with early (stage 1-3; 65%) or advanced (stage 4-5 or end-stage kidney disease [ESKD]; 33%) CKD. People within the PH-CKD group were ~5 years older than the overall PH population. Pharmacotherapy, particularly potassium citrate (33%), was more common in people with PH and early-stage CKD, while people with PH and advanced CKD were more likely to undergo procedural interventions, including dialysis (48%) and kidney transplant (16%). People with PH and advanced CKD had ~13x and ~5x higher median all-cause semi-annual healthcare costs compared to people with only PH or PH-CKD (stage 1-3), respectively. The PH-CKD cohort had higher burden compared to the matched non-PH-CKD group, including higher rates of kidney stones and urinary tract infections (p<0.05). The PH-CKD cohort had higher use of potassium citrate (stage 1-3; p<0.05) and dialysis (stage 4-5/ESKD; p<0.05) compared with the non-PH-CKD. PH-CKD (stage 1-3) had higher utilization and cost differences (~2x) compared to a matched non-PH-CKD cohort.

Conclusion

People with PH-CKD show a higher clinical and economic burden of illness compared to non-PH-CKD people. Among people with PH, the health burden increases with CKD stage.

Funding

  • Commercial Support –  Novo Nordisk Inc.