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. Author manuscript; available in PMC: 2013 Aug 9.
Published in final edited form as: Am J Kidney Dis. 2013 Apr;61(4 0 2):S24–S32. doi: 10.1053/j.ajkd.2012.12.015

Table 3.

Rates of Death by Health Insurance Status

Stratified by CKD Stage
CKD Stage
Overall No CKD 1–2 3a 3b 4–5
No. of participants 86,588 73,590 7,162 4,417 1,036 383
No. of events 1,020 625 196 113 54 32
Person-years 365,730.34 313,589.99 30,302.08 16,927.09 3,569.77 1,333.43
Rate per 1,000 person-years 2.79 1.99 6.47 6.68 15.13 24.00
  No insurance 3.17 2.32 6.78 7.37 14.25 23.62
  Public insurance 8.10 5.14 16.15 17.04 32.71 37.60
  Private insurance 1.88 1.47 4.18 4.13 8.28 18.33
HRa (95% CI) unadjusted
  No insurance vs private 1.73 (1.50–2.01) 1.63 (1.36–1.96) 1.66 (1.19–2.33) 1.80 (1.12–2.87) 1.77 (0.84–3.74) 1.36 (0.57–3.25)
  Public insurance vs private 4.42 (3.81–5.14) 3.60 (2.94–4.40) 3.97 (2.82–5.59) 4.18 (2.72–6.42) 4.12 (2.21–7.68) 2.20 (0.96–5.04)
HRb (95% CI) adjusted for only
    demographic variables
  No insurance vs private 1.82 (1.56–2.12) 1.68 (1.39–2.04) 1.66 (1.18–2.36) 1.84 (1.13–2.98) 1.91 (0.89–4.10) 1.46 (0.59–3.64)
  Public insurance vs private 3.22 (2.76–3.76) 2.58 (2.09–3.18) 3.22 (2.27–4.57) 3.63 (2.34–5.65) 3.43 (1.81–6.50) 1.91 (0.79–4.65)
HRc,d (95% CI) adjusted for
    variables potentially in the
    causal pathway
  No insurance vs private 1.65 (1.42–1.93) 1.65 (1.37–2.00) 1.59 (1.12–2.25) 1.55 (0.94–2.57) 2.10 (0.88–5.05)
  Public insurance vs private 2.40 (2.04–2.82) 2.30 (1.86–2.84) 2.74 (1.92–3.91) 2.35 (1.44–3.85) 1.87 (0.89–3.96)
HRd (95% CI) adjusted for the
    above variables + eGFR
  No insurance vs private 1.66 (1.43–1.94) 1.65 (1.36–1.99) 1.60 (1.13–2.26) 1.56 (0.94–2.57) 2.07 (0.86–4.97)
  Public insurance vs private 2.37 (2.01–2.78) 2.30 (1.86–2.84) 2.73 (1.91–3.90) 2.33 (1.43–3.81) 1.89 (0.89–4.01)

Stratified by eGFR
eGFR >60 eGFR = 30–59 (CKD stage 3) eGFR <30 (CKD stages 4–5)

HRb (95% CI) adjusted for only demographic variables
  No insurance vs private 1.76 (1.49–2.08) 1.86 (1.24–2.80) 1.46 (0.59–3.64)
  Public insurance vs private
2.89 (2.42–3.45) 3.82 (2.66–5.47) 1.91 (0.79–4.65)

Abbreviations: CI, confidence interval; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate (in mL/min/1.73 m2); HR, hazard ratio.

a

Unadjusted.

b

Models adjusted for age, sex, race, ethnicity, education, and smoking.

c

Models adjusted for age, sex, race, ethnicity, education, smoking, hypertension, diabetes, cardiovascular disease, albuminuria, and body mass index.

d

At CKD stages 4–5, all deaths are in participants with hypertension regardless of whether they had insurance. The HR for hypertension is close to infinity, resulting in an unreliable model.