Table 4.

Rates of ESRD 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	341	23	65	43	62	148
Person-years	364,858.95	313,533.01	30,177.23	16,833.57	3,426.75	880.41
Rate per 1,000 person-years	0.94	0.07	2.15	2.55	18.09	169.24
No insurance	1.15	0.10	2.38	3.33	26.35	163.40
Public insurance	2.36	0.19	2.93	4.29	28.03	168.26
Private insurance	0.65	0.05	1.86	1.89	10.61	170.99
HRa (95% CI) unadjusted
No insurance vs private	1.77 (1.38–2.27)	2.25 (0.89–5.71)	1.36 (0.79–2.34)	1.80 (0.90–3.62)	2.58 (1.40–4.77)	0.89 (0.61–1.29)
Public insurance vs private	3.62 (2.76–4.74)	4.10 (1.40–12.0)	1.69 (0.85–3.36)	2.34 (1.09–5.00)	2.72 (1.47–5.02)	0.89 (0.59–1.35)
HRb (95% CI) adjusted for only     demographic variables
No insurance vs private	1.72 (1.33–2.22)	2.01 (0.75–5.35)	1.29 (0.73–2.26)	1.35 (0.65–2.81)	2.88 (1.55–5.36)	0.89 (0.60–1.33)
Public insurance vs private	2.74 (2.08–3.62)	3.06 (1.01–9.27)	1.45 (0.72–2.92)	1.95 (0.89–4.29)	3.14 (1.67–5.88)	0.91 (0.59–1.40)
HRc,d (95% CI) adjusted for     variables potentially in the     causal pathway
No insurance vs private	1.15 (0.88–1.51)	1.89 (0.71–5.00)	1.17 (0.67–2.04)	0.87 (0.39–1.94)	—	0.73 (0.47–1.14)
Public insurance vs private	1.54 (1.14–2.07)	2.57 (0.84–7.83)	1.25 (0.62–2.52)	1.41 (0.62–3.19)	—	0.98 (0.62–1.55)
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		1.77 (1.09–2.90)		2.09 (1.31–3.35)	0.89 (0.60–1.33)
Public insurance vs private		2.13 (1.18–3.85)		3.10 (1.92–5.00)	0.91 (0.59–1.40)

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

^aUnadjusted.

^bModels adjusted for age, sex, race, ethnicity, education, and smoking.

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

^dAt CKD stage 3b, all the ESRD outcomes are for participants with hypertension regardless of whether they had insurance. The HR for hypertension is close to infinity, resulting in an unreliable model.