Table 1. Characteristics of veterans with advanced CKD.
| All (N=39,669) | Nephrology care | P-value | ||
|---|---|---|---|---|
| Yes (n=14,983) | No (n=24,686) | |||
| Age, y | 75.9 ±11.0 | 72.5 ±10.7 | 77.9 ±10.6 | <0.001 |
| Age group | <0.001 | |||
| 21-64 y | 8,172 (20.6%) | 4,308 (28.8) | 3,864 (15.7%) | |
| 65-74 y | 8,910 (22.5%) | 4,096 (27.3%) | 4,814 (19.5%) | |
| ≥75 y | 22,587 (56.9%) | 6,579 (43.9) | 16,008 (64.9%) | |
| Sex | 0.001 | |||
| Female | 1,166 (2.9%) | 387 (2.6%) | 779 (3.2%) | |
| Male | 38,503 (97.1%) | 14,596 (97.4%) | 23,907 (96.8%) | |
| Race | <0.001 | |||
| White | 29,180 (73.6%) | 10,110 (67.5%) | 19,070 (77.3%) | |
| Black | 6,453 (16.3%) | 3,382 (22.6%) | 3,071 (12.4%) | |
| Other | 3,165 (8.0%) | 1,239 (8.3%) | 1,926 (7.8%) | |
| Missing | 871 (2.2%) | 252 (1.7%) | 619 (2.5%) | |
| Marital status | 0.6 | |||
| Married | 21,379 (53.9%) | 8,050 (53.7%) | 13,329 (54.0%) | |
| Other | 18,290 (46.1%) | 6,933 (46.3%) | 11,357 (46.0%) | |
| Residence | 0.01 | |||
| Suburban, rural, small town | 5,552 (14.0%) | 1,897 (12.7%) | 3,655 (14.8%) | |
| Urban | 33,197 (83.7%) | 12,741 (85.0%) | 20,456 (82.9%) | |
| Missing | 920 (2.3%) | 345 (2.3%) | 575 (2.3%) | |
| Copay status+ | 0.3 | |||
| No copay | 29,820 (75.2%) | 10,663 (71.2%) | 19,157 (77.6%) | |
| Copay | 9,789 (24.7%) | 4,295 (28.7%) | 5,494 (22.3%) | |
| Missing | 60 (0.2%) | 25 (0.1%) | 35 (0.1%) | |
| Zip code median annual income | 0.001 | |||
| <$35,000 | 6,794 (17.1%) | 2,706 (18.1%) | 4,088 (16.6%) | |
| $35,000-<$50,000 | 16,005 (40.3%) | 5,925 (39.5%) | 10,080 (40.8%) | |
| $50,000-<$65,000 | 9,484 (23.9%) | 3,601 (24.0%) | 5,883 (23.8%) | |
| ≥$65,000 | 6,692 (16.9%) | 2,483 (16.6%) | 4,209 (17.1%) | |
| Missing | 694 (1.7%) | 268 (1.8%) | 426 (1.7%) | |
| Facility complexity+ | <0.001 | |||
| Low | 3,503 (8.8%) | 983 (6.6%) | 2,520 (10.2%) | |
| Mid | 6,246 (15.7%) | 2,433 (16.2%) | 3,813 (15.4%) | |
| High | 29,541 (74.5%) | 11,454 (76.4%) | 18,087 (73.3%) | |
| Missing | 379 (1.0%) | 113 (0.7%) | 266 (1.1%) | |
| Comorbidities | ||||
| Diabetes | 22,299 (56.2%) | 9,165 (61.2%) | 13,134 (53.2%) | <0.001 |
| Myocardial infarction | 2,676 (6.7%) | 960 (6.4%) | 1,716 (7.0%) | 0.03 |
| Congestive heart failure | 11,741 (29.6%) | 4,360 (29.1%) | 7,381 (29.9%) | 0.09 |
| Peripheral vascular disease | 7,741 (19.5%) | 3,006 (20.1%) | 4,735 (19.2%) | 0.03 |
| Dementia | 2,709 (6.8%) | 675 (4.5%) | 2,034 (8.2%) | <0.001 |
| Cerebrovascular disease | 6,151 (15.5%) | 2,255 (15.0%) | 3,896 (15.8%) | 0.05 |
| Chronic liver disease | 1266 (3.2%) | 607 (4.1%) | 659 (2.7%) | <0.001 |
| Cancer | 8,018 (20.2%) | 2,919 (19.5%) | 5,099 (20.6%) | 0.005 |
| Depression | 8,204 (20.7%) | 3,299 (22.0%) | 4,905 (19.9%) | <0.001 |
| PTSD | 3,104 (7.8%) | 1,344 (9.0%) | 1,760 (7.1%) | <0.001 |
| Prior hospitalization | 10,515 (26.5%) | 4,306 (28.7%) | 6209 (25.2%) | <0.001 |
| Visits to non-nephrology provider | <0.001 | |||
| 0 | 3,940 (9.9%) | 1,144 (7.6%) | 2,796 (11.3%) | |
| 1-2 | 8,763 (22.1%) | 2,731 (18.2%) | 6,032 (24.4%) | |
| 3-4 | 8,774 (22.1%) | 3,014 (20.1%) | 5,760 (23.3%) | |
| ≥5 | 18,192 (45.9%) | 8,094 (54.0%) | 10,098 (40.9%) | |
| Index eGFR (ml/min/1.73 m2) | 25.1 ± 4.5 | 24.8 ± 4.5 | 25.2 ± 4.5 | <0.001 |
| eGFR trajectory | <0.001 | |||
| Improvement | 11,970 (30.2%) | 5,818 (38.8%) | 6,152 (24.9%) | |
| Decline < 10 ml/min/ 1.73m2 per y | 12,136 (30.6%) | 5,129 (34.2%) | 7,007 (28.4%) | |
| Decline ≥10 ml/min/ 1.73m2 per y | 13,609 (34.3%) | 3,816 (25.5%) | 9,793 (39.7%) | |
| Missing or time lapse <30 d | 1,954 (4.9%) | 220 (1.5%) | 1,734 (7.0%) | |
Note: Values for categorical variables are given as number (percentage); for continuous variables, as mean ± standard deviation.
Abbreviations: CKD, chronic kidney disease; ESRD – end-stage renal disease, PTSD – post traumatic stress disorder, eGFR – estimated glomerular filtration rate
+
Copay is based on a veteran's service-connected condition and financial status.33 Department of Veterans Affairs facilities are categorized according to complexity level, which is based on patient characteristics, clinical services offered, educational and research missions and administrative complexity. 34