Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Feb 11, 2024
Date Accepted: May 17, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Prevalence, Mortality, and Access to Care for Chronic Kidney Disease in Medicaid-Enrolled Adults with Sickle Cell Disease: A Retrospective Cohort Study in California
ABSTRACT
Background:
Background:
Chronic Kidney Disease (CKD) is a significant complication in sickle cell disease (SCD) patients, leading to increased mortality. However, there is limited contemporary data on the prevalence, burden, and access to care for CKD in adult SCD patients, particularly those outside specialized clinics.
Objective:
This study aims to investigate the burden of CKD in Medicaid-enrolled adults with SCD in California and assess mortality rates and access to specialized care.
Methods:
Methods:
This retrospective cohort study utilized the California Sickle Cell Data Collection (SCDC) program, which combines various data sources to identify and monitor individuals with SCD. Medicaid claims, emergency department, and hospitalization data from 2011 to 2020 were analyzed. CKD prevalence was assessed based on ICD codes, and mortality rates were calculated. Access to specialized care was examined through outpatient encounter rates with hematologists and nephrologists.
Results:
Results:
Among the 2,345 adults with SCD, 24.4% met the case definition for CKD. Prevalence of CKD increased with age, with notable differences between males and females. Mortality rates were higher in the SCD-CKD cohort, particularly in males. Access to specialized care was limited, with a significant proportion of individuals having no encounters with hematologists or nephrologists. Deceased patients had lower rates of visits to both specialists compared to surviving patients.
Conclusions:
Conclusion: This study provides robust estimates of CKD prevalence among Medicaid-enrolled adults with SCD in California. The findings highlight the need for improved access to specialized care for this population and increased awareness of the high mortality risk and progression associated with CKD.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.