Assessing the Impact of a Renal Care Management Program on Disease Progression: An Observational Cohort Study - Abstract
Introduction: There are few observational studies evaluating the effects renal care management programs have on the transition from chronic kidney disease to end stage renal disease, marked by initiation of dialysis. This limits the understanding of the quantitative effectiveness of such programs.
Methods: A retrospective cohort study of CKD patients with or without access to a renal care management program was completed. Propensity score 1:1 matching was used to balance the comparison groups on demographic and clinical characteristics. Healthcare claims data was used to determine whether program access affected the rate of transition to dialysis and the likelihood of transitioning to dialysis.
Results: We followed the cohort of 5,912 patients (2,956 with access to a renal care management program and 2,956 without access to the program) during a two-year period. Those with access to the program transitioned to dialysis later than those without access to the program. Further, those with access to the program had a 22 percent reduced risk of initiating dialysis compared to those without access to the program.
Conclusions: Patients with stage 4 or 5 chronic kidney disease who have access to renal care management have a reduced risk of transitioning to dialysis as well as a later transition to dialysis compared to CKD patients without access to renal care management.