Economic burden of inpatient hospitalizations for pediatric chronic kidney disease in the US.
Document Type
Article
Publication Date
4-2025
Identifier
DOI: 10.1007/s00467-024-06568-2
Abstract
BACKGROUND: Children with chronic kidney disease (CKD) face extensive healthcare needs, leading to substantial financial strain on both families and healthcare systems due to costly kidney replacement therapies and associated comorbidities. Limited research on inpatient healthcare utilization is available for the individual stages of pediatric CKD.
METHODS: This retrospective cohort study included inpatient encounters for pediatric patients (≤ 18 years) using the Pediatric Health Information System Database (PHIS) between January 2016 and December 2022, with an ICD-10 code for any CKD stage (1-5). Hospitalization cost, length of stay (LOS), morbidity, and mortality data were collected.
RESULTS: We identified 23,980 pediatric CKD cases [stage 1: 5,059, stage 2: 6,763, stage 3: 7,012, stage 4: 3,102, and stage 5: 2,044] across 49 different children's hospitals in the United States. Mortality rates were observed to increase with increasing CKD severity, but no clear trend was observed for surgical, medical, and infection rates by CKD stage. The LOS for patients with CKD stage 4 and CKD stage 5 was 56% and 71% longer relative to the LOS of a typical hospitalization for a patient without CKD, and the billed charges for these hospitalizations were 92% and 147% higher than those of a typical hospitalization.
CONCLUSIONS: LOS and hospitalization costs were significantly higher for patients with CKD than for patients without CKD. Furthermore, pediatric patients with stage 5 CKD had significantly higher in-patient costs and all-cause hospitalization LOS compared to those with CKD stages 1-4.
Journal Title
Pediatric nephrology (Berlin, Germany)
Volume
40
Issue
4
First Page
1059
Last Page
1068
MeSH Keywords
Humans; Child; Retrospective Studies; Male; Female; United States; Adolescent; Renal Insufficiency, Chronic; Hospitalization; Child, Preschool; Length of Stay; Infant; Cost of Illness; Hospital Costs; Infant, Newborn; Severity of Illness Index; Databases, Factual
PubMed ID
39508870
Keywords
Chronic kidney disease (CKD); Cost; Length of stay (LOS); Mortality
Recommended Citation
Taliwal N, Pandya A, Dixon A, et al. Economic burden of inpatient hospitalizations for pediatric chronic kidney disease in the US. Pediatr Nephrol. 2025;40(4):1059-1068. doi:10.1007/s00467-024-06568-2
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