Epidemiology and burden of focal segmental glomerulosclerosis among United States Veterans: An analysis of Veteran's Affairs data
Focal segmental glomerulosclerosis (FSGS) is a rare glomerular disease that can lead to reduced kidney function and kidney failure (KF). The objective of this study was to describe the epidemiology, characteristics, clinical outcomes, healthcare resource utilization, and costs associated with focal...
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| description | Focal segmental glomerulosclerosis (FSGS) is a rare glomerular disease that can lead to reduced kidney function and kidney failure (KF). The objective of this study was to describe the epidemiology, characteristics, clinical outcomes, healthcare resource utilization, and costs associated with focal segmental glomerulosclerosis (FSGS) in United States (US) veterans.
This retrospective cohort study included patients in the National Veterans Affairs Health Care Network with ≥2 FSGS-associated diagnostic codes that were 30-180 days apart (October 1999-February 2021). Annual FSGS incidence and prevalence per 1,000,000 US veterans were calculated. Patient and disease characteristics as of the index date (date of first FSGS diagnosis) and baseline (6-months pre-index) comorbidities were described. Kaplan-Meier analyses were used to assess overall survival and time from index to KF or death, dialysis, and kidney transplant. Post-index medication use, HRU, and direct healthcare costs were summarized.
The study included 2,515 veterans with FSGS who were followed for an average of 8.9 years. The mean age was 57.5 years, most patients were male (94.6%), and the most common comorbidity was hypertension (87.0%). The mean annual incidence and prevalence of FSGS during 2000-2020 were 19.6 and 164.7 per million veterans, respectively. Approximately half (51.5%) died during follow-up (median time: 11.6 years) and 76.9% had kidney failure (4.1 years). Overall, 43.3% underwent dialysis and 5.8% had a kidney transplant. During follow-up, statins and calcium channel blockers were commonly used (81.9% and 75.1%). During the first year post-index, 40% had an inpatient admission and 33% visited the emergency room; mean total healthcare cost per patient in the analysis was $36,543.
Among US veterans, FSGS is associated with considerable clinical and economic burdens. Better treatments for FSGS are needed to slow kidney disease progression, improve patient outcomes, and reduce the burden. |
| doi_str_mv | 10.1371/journal.pone.0315302 |
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This retrospective cohort study included patients in the National Veterans Affairs Health Care Network with ≥2 FSGS-associated diagnostic codes that were 30-180 days apart (October 1999-February 2021). Annual FSGS incidence and prevalence per 1,000,000 US veterans were calculated. Patient and disease characteristics as of the index date (date of first FSGS diagnosis) and baseline (6-months pre-index) comorbidities were described. Kaplan-Meier analyses were used to assess overall survival and time from index to KF or death, dialysis, and kidney transplant. Post-index medication use, HRU, and direct healthcare costs were summarized.
The study included 2,515 veterans with FSGS who were followed for an average of 8.9 years. The mean age was 57.5 years, most patients were male (94.6%), and the most common comorbidity was hypertension (87.0%). The mean annual incidence and prevalence of FSGS during 2000-2020 were 19.6 and 164.7 per million veterans, respectively. Approximately half (51.5%) died during follow-up (median time: 11.6 years) and 76.9% had kidney failure (4.1 years). Overall, 43.3% underwent dialysis and 5.8% had a kidney transplant. During follow-up, statins and calcium channel blockers were commonly used (81.9% and 75.1%). During the first year post-index, 40% had an inpatient admission and 33% visited the emergency room; mean total healthcare cost per patient in the analysis was $36,543.
Among US veterans, FSGS is associated with considerable clinical and economic burdens. Better treatments for FSGS are needed to slow kidney disease progression, improve patient outcomes, and reduce the burden.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0315302</identifier><identifier>PMID: 39671357</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Calcium channel blockers ; Calcium channels ; Clinical outcomes ; Codes ; Comorbidity ; Cost of Illness ; Creatinine ; Data warehouses ; Development and progression ; Dialysis ; Emergency medical care ; Emergency medical services ; Epidemiology ; Ethnicity ; Female ; Glomerulosclerosis, Focal Segmental - economics ; Glomerulosclerosis, Focal Segmental - epidemiology ; Health aspects ; Health care ; Hemodialysis ; Humans ; Hypertension ; Incidence ; Kidney diseases ; Kidney transplantation ; Kidney transplants ; Male ; Mean ; Methods ; Middle Aged ; Patients ; Prevalence ; Quality of life ; Renal failure ; Resource utilization ; Retrospective Studies ; Statins ; United States - epidemiology ; United States Department of Veterans Affairs ; Veterans ; Veterans - statistics & numerical data</subject><ispartof>PloS one, 2024-12, Vol.19 (12), p.e0315302</ispartof><rights>Copyright: © 2024 Goldschmidt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Goldschmidt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Goldschmidt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4312-aae0582eeea056dcc1db75b6639f6dc0c64d6969af22deaeb219fd316471c3963</cites><orcidid>0000-0002-5940-7898 ; 0000-0001-7040-4287</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0315302&type=printable$$EPDF$$P50$$Gplos$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0315302$$EHTML$$P50$$Gplos$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,862,2098,2917,23853,27911,27912,79355,79356</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39671357$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Li, Meng</contributor><creatorcontrib>Goldschmidt, Deborah</creatorcontrib><creatorcontrib>Bensink, Mark E</creatorcontrib><creatorcontrib>Zhou, Zheng-Yi</creatorcontrib><creatorcontrib>Shi, Sherry</creatorcontrib><creatorcontrib>Lin, Yilu</creatorcontrib><creatorcontrib>Shi, Lizheng</creatorcontrib><title>Epidemiology and burden of focal segmental glomerulosclerosis among United States Veterans: An analysis of Veteran's Affairs data</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Focal segmental glomerulosclerosis (FSGS) is a rare glomerular disease that can lead to reduced kidney function and kidney failure (KF). The objective of this study was to describe the epidemiology, characteristics, clinical outcomes, healthcare resource utilization, and costs associated with focal segmental glomerulosclerosis (FSGS) in United States (US) veterans.
This retrospective cohort study included patients in the National Veterans Affairs Health Care Network with ≥2 FSGS-associated diagnostic codes that were 30-180 days apart (October 1999-February 2021). Annual FSGS incidence and prevalence per 1,000,000 US veterans were calculated. Patient and disease characteristics as of the index date (date of first FSGS diagnosis) and baseline (6-months pre-index) comorbidities were described. Kaplan-Meier analyses were used to assess overall survival and time from index to KF or death, dialysis, and kidney transplant. Post-index medication use, HRU, and direct healthcare costs were summarized.
The study included 2,515 veterans with FSGS who were followed for an average of 8.9 years. The mean age was 57.5 years, most patients were male (94.6%), and the most common comorbidity was hypertension (87.0%). The mean annual incidence and prevalence of FSGS during 2000-2020 were 19.6 and 164.7 per million veterans, respectively. Approximately half (51.5%) died during follow-up (median time: 11.6 years) and 76.9% had kidney failure (4.1 years). Overall, 43.3% underwent dialysis and 5.8% had a kidney transplant. During follow-up, statins and calcium channel blockers were commonly used (81.9% and 75.1%). During the first year post-index, 40% had an inpatient admission and 33% visited the emergency room; mean total healthcare cost per patient in the analysis was $36,543.
Among US veterans, FSGS is associated with considerable clinical and economic burdens. Better treatments for FSGS are needed to slow kidney disease progression, improve patient outcomes, and reduce the burden.</description><subject>Adult</subject><subject>Aged</subject><subject>Calcium channel blockers</subject><subject>Calcium channels</subject><subject>Clinical outcomes</subject><subject>Codes</subject><subject>Comorbidity</subject><subject>Cost of Illness</subject><subject>Creatinine</subject><subject>Data warehouses</subject><subject>Development and progression</subject><subject>Dialysis</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Epidemiology</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Glomerulosclerosis, Focal Segmental - economics</subject><subject>Glomerulosclerosis, Focal Segmental - epidemiology</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Incidence</subject><subject>Kidney diseases</subject><subject>Kidney transplantation</subject><subject>Kidney transplants</subject><subject>Male</subject><subject>Mean</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Prevalence</subject><subject>Quality of life</subject><subject>Renal failure</subject><subject>Resource utilization</subject><subject>Retrospective Studies</subject><subject>Statins</subject><subject>United States - 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Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goldschmidt, Deborah</au><au>Bensink, Mark E</au><au>Zhou, Zheng-Yi</au><au>Shi, Sherry</au><au>Lin, Yilu</au><au>Shi, Lizheng</au><au>Li, Meng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology and burden of focal segmental glomerulosclerosis among United States Veterans: An analysis of Veteran's Affairs data</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-12-13</date><risdate>2024</risdate><volume>19</volume><issue>12</issue><spage>e0315302</spage><pages>e0315302-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Focal segmental glomerulosclerosis (FSGS) is a rare glomerular disease that can lead to reduced kidney function and kidney failure (KF). The objective of this study was to describe the epidemiology, characteristics, clinical outcomes, healthcare resource utilization, and costs associated with focal segmental glomerulosclerosis (FSGS) in United States (US) veterans.
This retrospective cohort study included patients in the National Veterans Affairs Health Care Network with ≥2 FSGS-associated diagnostic codes that were 30-180 days apart (October 1999-February 2021). Annual FSGS incidence and prevalence per 1,000,000 US veterans were calculated. Patient and disease characteristics as of the index date (date of first FSGS diagnosis) and baseline (6-months pre-index) comorbidities were described. Kaplan-Meier analyses were used to assess overall survival and time from index to KF or death, dialysis, and kidney transplant. Post-index medication use, HRU, and direct healthcare costs were summarized.
The study included 2,515 veterans with FSGS who were followed for an average of 8.9 years. The mean age was 57.5 years, most patients were male (94.6%), and the most common comorbidity was hypertension (87.0%). The mean annual incidence and prevalence of FSGS during 2000-2020 were 19.6 and 164.7 per million veterans, respectively. Approximately half (51.5%) died during follow-up (median time: 11.6 years) and 76.9% had kidney failure (4.1 years). Overall, 43.3% underwent dialysis and 5.8% had a kidney transplant. During follow-up, statins and calcium channel blockers were commonly used (81.9% and 75.1%). During the first year post-index, 40% had an inpatient admission and 33% visited the emergency room; mean total healthcare cost per patient in the analysis was $36,543.
Among US veterans, FSGS is associated with considerable clinical and economic burdens. Better treatments for FSGS are needed to slow kidney disease progression, improve patient outcomes, and reduce the burden.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39671357</pmid><doi>10.1371/journal.pone.0315302</doi><tpages>e0315302</tpages><orcidid>https://orcid.org/0000-0002-5940-7898</orcidid><orcidid>https://orcid.org/0000-0001-7040-4287</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2024-12, Vol.19 (12), p.e0315302 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_3144310638 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Aged Calcium channel blockers Calcium channels Clinical outcomes Codes Comorbidity Cost of Illness Creatinine Data warehouses Development and progression Dialysis Emergency medical care Emergency medical services Epidemiology Ethnicity Female Glomerulosclerosis, Focal Segmental - economics Glomerulosclerosis, Focal Segmental - epidemiology Health aspects Health care Hemodialysis Humans Hypertension Incidence Kidney diseases Kidney transplantation Kidney transplants Male Mean Methods Middle Aged Patients Prevalence Quality of life Renal failure Resource utilization Retrospective Studies Statins United States - epidemiology United States Department of Veterans Affairs Veterans Veterans - statistics & numerical data |
| title | Epidemiology and burden of focal segmental glomerulosclerosis among United States Veterans: An analysis of Veteran's Affairs data |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T18%3A13%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Epidemiology%20and%20burden%20of%20focal%20segmental%20glomerulosclerosis%20among%20United%20States%20Veterans:%20An%20analysis%20of%20Veteran's%20Affairs%20data&rft.jtitle=PloS%20one&rft.au=Goldschmidt,%20Deborah&rft.date=2024-12-13&rft.volume=19&rft.issue=12&rft.spage=e0315302&rft.pages=e0315302-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0315302&rft_dat=%3Cgale_plos_%3EA819786143%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3144310638&rft_id=info:pmid/39671357&rft_galeid=A819786143&rft_doaj_id=oai_doaj_org_article_7f3d88922d5c42fa9507b2cdc9fdaaeb&rfr_iscdi=true |