Prevalence, Mortality, and Access to Care for Chronic Kidney Disease in Medicaid-Enrolled Adults With Sickle Cell Disease in California: Retrospective Cohort Study

• DOI: 10.2196/57290
• Publication Date: 2024-05-17T05:42:46Z
• Authors: Jhaqueline Valle; Jeffrey D Lebensb...; Pranav S Garimella; Srila Gopal
• Keywords: Preprint

Background Chronic kidney disease (CKD) is a significant complication in patients with sickle cell (SCD), leading to increased mortality. Objective This study aims investigate the burden of CKD Medicaid-enrolled adults SCD California, examine differences between male and female individuals, assess mortality rates access specialized care. Methods retrospective cohort used California Sickle Cell Data Collection program identify monitor individuals SCD. Medicaid claims, vital records, emergency department, hospitalization data from 2011 2020 were analyzed. prevalence was assessed based on ICD (International Classification Diseases) codes, calculated. Access care examined through outpatient encounter hematologists nephrologists. Results Among 2345 SCD, 24.4% (n=572) met case definition for CKD. The SCD-CKD group older at beginning this (average age 44, SD 14 vs 34, 12.6 years) than without age, revealing disparities by sex. While youngest (18-29 oldest (>65 groups showed similar prevalences sexes (female: 12/111, 10.8% male: 12/101, 11.9%; female: 74/147, 50.3% 34/66, 51.5%, respectively), aged 30-59 years bracket exhibited significantly higher (30-39 years: 49/294, 16.7%, P=.01; 40-49 52/182, 28.6%, P=.02; 50-59 76/157,48.4%, P<.001). During study, adults, 435 (18.5%) deaths occurred, predominantly within (226/435, 39.5%). median death 53 (IQR 61-44) compared 43 33-56) group, showing (111/242, 45.9%; P=.009) (115/330, 34.9%). specialist notably limited: approximately half (281/572, 49.1%) had no hematologist visits, 61.9% (354/572) did not see nephrologist during study’s period. Conclusions provides robust estimates among California. findings highlight need improved population awareness high risk progression associated