Abstract

BACKGROUND
Diabetes is becoming one of the main causes of end-stage renal disease (ESRD) worldwide. We studied the prevalence and incidence of end-stage renal disease (ESRD) in the Korean population based on health insurance claims submitted to the Health Insurance Review Agency. We also investigated the proportion of medications taken by the ESRD patients, and frequency of hospital admission or visits, and medical expenses between ESRD patients with and without diabetes. METHODS: This study was based on health insurance claims submitted to the Health Insurance Review Agency during the period from January 2001 through December 2003. Using the disease-classification codes on the health insurance claim forms, those who were diagnosed with chronic renal disease (N18 or N19) and received dialysis-related treatment (Z49), treatment with a kidney dialysis machine (Z99.2), or kidney transplantation (Z94.0) were defined as ESRD patients. Among the ESRD patients, those who were diagnosed with diabetes (E10-E14) and/or took anti-diabetic drugs were defined as ESRD patients with diabetes. RESULTS: The ESRD patients totaled 33,870 in 2001, 37,894 in 2002, and 41,167 (858.3 per million population) in 2003. ESRD patients with diabetes increased to 56.7% in 2003. The number of ESRD patients in whom renal replacement therapy was initiated was 8,134 in 2002 and 8,322 (173.5 per million population) in 2003. ESRD patients with diabetes used more anti-hypertensive drugs (1.2 times as many), lipid-lowering drugs (1.6 times), and anti-platelet agents (1.8 times) than did ESRD patients without diabetes. In 2003, 66.5% of the ESRD patients with diabetes were hospitalized, which was 1.6 times the hospital admissions of ESRD patients without diabetes. ESRD patients with diabetes also had hospital stays that were 1.6 times longer per patient and inpatient service expenses that were 1.6times greater per patient, compared with those reported for ESRD patients without diabetes. CONCLUSION: The incidence of ESRD accompanied by diabetes has risen rapidly. Given the burden of medical treatment costs placed on ESRD patients with diabetes, more aggressive interventions should be implemented to prevent diabetes and renal complications among patients with diabetes.

• Keywords: Cost;Diabetes;End-stage renal disease;Incidence;Prevalence;