Genetic kidney disease has a higher likelihood and cost of inpatient admissions compared to other aetiologies

Purpose: There is increasing recognition of monogenic aetiologies for kidney disease. We sought to identify whether genetic kidney disease (GKD) has distinct hospitalization patterns compared to other forms of chronic kidney disease (CKD). Methods: Health service utilization analysis was undertaken in a CKD cohort study across public hospital services in Queensland, Australia. CKD due to clinically coded potential monogenic causes was compared to all other causes in terms of annual frequency, cost, and type of hospital admission. Results: We analyzed 7 years of hospital admissions data (809,188 admissions) among 29,046 patients. Compared to non-genetic CKD, GKD was associated with a higher likelihood and cost of admissions. GKD had consistently more admissions (mean excess annual number of admissions increasing from 5.2 in year 1 to 13.4 in year 7) and more costly admissions (mean excess annual cost increasing from $5,265 in year 1 to $12,993 in year 7). This gap in hospitalization likelihood and cost increased over time for both surgical and medical admission episodes, but not for all (immunological, cancer) causes of admissions. Conclusion: Understanding the nature and extent of differences in healthcare needs between GKD and other CKD will enable better secondary prevention and inform resource allocation decisions to reduce healthcare system pressures attributable to knowable causes.