Non-technique-related healthcare utilization and costs among dialysis and kidney transplant recipients in Spain: a real-world analysis.
10 affiliations
- 1Nephrology Service, Reina Sofia University Hospital, Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC), University of Cordoba, Cordoba, Spain.
- 2Cardiology Service, University Hospital La Paz, Madrid, Spain. [email protected].
- 3Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, 20878, USA.
- 4BioPharmaceuticals Medical, AstraZeneca, Madrid, 28050, Spain.
- 5BioPharmaceuticals Corporate Affairs & Market Access, AstraZeneca, Madrid, 28050, Spain.
- 6Atrys Health, Madrid, 28002, Spain.
- 7Primary Care Center Cartagena Casco, Cartagena, Murcia, Spain.
- 8Biomedical Research Institute of Murcia (IMIB), Murcia, Spain.
- 9Nephrology Service, Hospital Universitario Central de Asturias, Oviedo, Spain.
- 10Nephrology Service, University Hospital Infanta Leonor, Madrid, Spain.
Abstract
Background
Kidney failure requiring kidney replacement therapy (KRT) is associated with a substantial and growing economic burden. While the costs directly attributable to KRT modalities are well documented, the resource use and costs unrelated to KRT modalities remain unclear.Objective
To quantify healthcare resource utilization (HCRU) and costs in patients receiving dialysis or kidney transplantation, excluding technique-related costs.Methods
This retrospective observational study used BIG-PAC real-world data to analyze dialysis or kidney transplant patients as of January 1, 2018, with a two-year follow-up. Patients were identified based on related diagnostic or procedure codes recorded in electronic health records (EHRs) prior to the index date. Major adverse cardiovascular events (MACE), hospitalization for CKD and mortality were evaluated. HCRU, direct healthcare costs, and indirect productivity costs due to sick leave were assessed, excluding technique-related KRT costs.Results
Of 70,973 individuals, 356 (0.5%) were on dialysis and 232 (0.3%) had kidney transplantation. Over two years, MACE per 1000 patient-years were 276.3 for dialysis and 85.9 for transplantation. CKD hospitalization rates were 245.7 and 183.0, with mortality rates of 253.8 and 35.6, respectively. First-year health costs averaged €25,410.4 (SD €17,369.0) for dialysis patients and €4,472.8 (SD €2,859.1) for transplant recipients. Most costs among dialysis and kidney transplant patients were driven by hospitalization, 72.4% and 39.8%, respectively. Indirect costs due to sick leave were also substantial.Conclusion
Non-technique-related costs represent a substantial component of the overall economic burden in patients receiving KRT, largely driven by hospitalizations. These findings provide important context for healthcare planning, although they do not represent total costs of care and should be interpreted as descriptive estimates.
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BibTeX
@article{santamaria2026nontechniquerelated,
title = {{Non-technique-related healthcare utilization and costs among dialysis and kidney transplant recipients in Spain: a real-world analysis.}},
author = {Rafael Santamaria and Carlos Escobar and Unai Aranda and Beatriz Palacios and Margarita Capel and Ignacio Hernández and Ana Cebrián and Manuel Gorostidi and Roberto Alcázar},
journal = {BMC nephrology},
year = {2026},
month = jul,
doi = {10.1186/s12882-026-05223-2},
url = {https://europepmc.org/article/MED/42897541},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Non-technique-related healthcare utilization and costs among dialysis and kidney transplant recipients in Spain: a real-world analysis.
AU - Rafael Santamaria
AU - Carlos Escobar
AU - Unai Aranda
AU - Beatriz Palacios
AU - Margarita Capel
AU - Ignacio Hernández
AU - Ana Cebrián
AU - Manuel Gorostidi
AU - Roberto Alcázar
PY - 2026
DA - 2026/07/01
JO - BMC nephrology
DO - 10.1186/s12882-026-05223-2
UR - https://europepmc.org/article/MED/42897541
AB - Background Kidney failure requiring kidney replacement therapy (KRT) is associated with a substantial and growing economic burden. While the costs directly attributable to KRT modalities are well documented, the resource use and costs unrelated to KRT modalities remain unclear.Objective To quantify healthcare resource utilization (HCRU) and costs in patients receiving dialysis or kidney transplantation, excluding technique-related costs.Methods This retrospective observational study used BIG-PAC real-world data to analyze dialysis or kidney transplant patients as of January 1, 2018, with a two-year follow-up. Patients were identified based on related diagnostic or procedure codes recorded in electronic health records (EHRs) prior to the index date. Major adverse cardiovascular events (MACE), hospitalization for CKD and mortality were evaluated. HCRU, direct healthcare costs, and indirect productivity costs due to sick leave were assessed, excluding technique-related KRT costs.Results Of 70,973 individuals, 356 (0.5%) were on dialysis and 232 (0.3%) had kidney transplantation. Over two years, MACE per 1000 patient-years were 276.3 for dialysis and 85.9 for transplantation. CKD hospitalization rates were 245.7 and 183.0, with mortality rates of 253.8 and 35.6, respectively. First-year health costs averaged €25,410.4 (SD €17,369.0) for dialysis patients and €4,472.8 (SD €2,859.1) for transplant recipients. Most costs among dialysis and kidney transplant patients were driven by hospitalization, 72.4% and 39.8%, respectively. Indirect costs due to sick leave were also substantial.Conclusion Non-technique-related costs represent a substantial component of the overall economic burden in patients receiving KRT, largely driven by hospitalizations. These findings provide important context for healthcare planning, although they do not represent total costs of care and should be interpreted as descriptive estimates.
SN - 1471-2369
ER -