Prevalence, resource utilization, and economic impact of kidney function and proteinuria in patients with focal...

Among patients with focal segmental glomerulosclerosis (FSGS), proteinuria and kidney function decline may be associated with increased economic burden. This study aimed to provide current information on the epidemiology and economic burden of FSGS in the United States.

In this descriptive, noninterventional, retrospective cohort study, 9899 patients were identified between January 2016 and December 2020 in Optum de-identified Market Clarity Data based on International Classification of Diseases code or Optum proprietary natural language processing data. Descriptive statistics were reported for categorical and continuous variables. Prevalence estimates were standardized to the age, gender, and race/ethnicity distribution of the general US population using direct methods and data from the 2021 United States Census Bureau. Per-patient-per-month health care resource utilization and associated costs (2024 US $) were reported by proteinuria (≤ 1.5 g/g vs > 1.5 g/g or < 3.5 g/g vs ≥ 3.5 g/g) and chronic kidney disease stage (stage 1-5/kidney failure). The Fisher exact test was used for categorical health care resource utilization outcomes, and linear regression (mean) and the Jonckheere-Terpstra test (medians) were used for continuous health care resource utilization and cost outcomes.

Estimated annual US prevalence (average for 2016-2020) of FSGS was 212.6 per 1 million. There was a consistent trend toward higher health care resource utilization and total costs with both chronic kidney disease progression (stage 1-5/kidney failure) and higher levels of proteinuria (≤ 1.5 g/g vs > 1.5 g/g or < 3 .5 g/g vs ≥ 3.5 g/g).

The observed prevalence of FSGS increased in the US and was highest among Black individuals. More advanced chronic kidney disease and higher levels of proteinuria were both associated with greater health care resource utilization and costs. Treatments that reduce proteinuria and slow kidney function decline have the potential to delay disease progression and to reduce the economic burden associated with FSGS.