CKD Among Children and Adolescents - 2018

(Gleaned from the 2018 USRDS Annual Data Report: Volume 1, Chapter 6: www.usrds.org)

A comparison of all children and those with CKD within the 1,970,375 privately insured children in the United States in 2016 indicates that overall, CKD was present in 2.7 cases per 1,000 children. CKD was most common in children under 4 years of age and adolescents age 18 to 21.

Coexisting conditions such as diabetes (4.1%), hypertension (8.8%) and cardiovascular diseases (10.3%) were more common in children with CKD than in the full pediatric population. Overall, in 2016, cardiovascular disease was present in 85 per 10,000 children and diabetes in 31 per 10,000 children. Concurrently diagnosed CKD and cardiovascular disease was present in 3 per 10,000 and CKD and diabetes was present in 1 per 10,000 children. Children with any of these three conditions account for 144 per 10,000 persons, or about 1.4 percent.

Overall, children with CKD have 12 times higher hospitalizations per 1,000 patient-years compared to all children. The youngest children, age 4 years and below, have the highest frequency of hospitalizations in the full and CKD pediatric subsets.

Healthcare expenditures were 7.6 times higher for children with CKD compared with non-CKD children in 2016. Over a 10-year period, between 2006 and 2016, single commercial healthcare expenditures for children with CKD increased by 47.6 percent from $10,200 per patient-year to $15,053 per patient-year. In comparison, expenditures for non-CKD children rose by 26.4 percent, from $1,571 to $1,985 per patient-year.

Summary:

• 2.7 per 1,000 children with healthcare coverage within a single commercial payer had chronic kidney disease (CKD)
• Hospitalization rates were 12 times higher for children with CKD than for all children
• Between 2006 and 2016, healthcare expenditures increased by 50% for children with CKD, compared to 25% for children without CKD
• Healthcare expenditures for children with CKD in 2016 were 7.6 times higher than expenditures for children without CKD