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Clinical / National Kidney Foundation (NKF)

Uninsured adults more likely to progress to kidney failure

April 04, 2013
KEYWORDS insurance / NKF
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Uninsured adults at high risk of kidney disease in the United States were more likely to progress to kidney failure or death than those with private health insurance coverage, according to new research presented at the National Kidney Foundation's Spring Clinical Meetings.

Researchers led by Claudine Jurkovitz, MD, MPH of Christiana Care Health System's Value Institute in Delaware found that compared with people covered by private or public insurance, those without insurance were more likely to be younger, Hispanic, and less likely to have seen a physician in the past year.

(Hispanics live longest, whites shortest among dialysis patients)

In one of the first studies to examine the association between lack of health insurance and the progression of chronic kidney disease to kidney failure, researchers used longitudinal data on more than 86,500 participants between the ages of 18 and 65 from the National Kidney Foundation’s Kidney Early Evaluation Program (KEEP). Uninsured KEEP participants were 82% more likely than privately insured participants to die and 72% more likely to experience kidney failure.

"Even among patients with normal or mildly decreased kidney function, the risk of developing kidney failure was higher for those without insurance than for those with private insurance. In the at-risk population, lack of insurance appears to be a risk factor for kidney failure, even in patients without advanced kidney disease," says Dr. Jurkovitz, a member of the KEEP Steering Committee and the Director of Operations in the Center for Outcomes Research under Christiana Care’s Value Institute, which studies health and health care with the goals of identifying and implementing strategies to achieve better health outcomes at lower costs.

 "In the United States, 73 million adults are at risk for chronic kidney disease due to having high blood pressure or diabetes. This study highlights that anyone at increased risk for developing kidney disease, and especially those without insurance coverage, should be regularly screened," says Beth Piraino, MD, National Kidney Foundation president.

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