Journal List > J Korean Diabetes Assoc > v.30(5) > 1062397

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Kim, Kim, Kim, Min, Park, Park, Park, Baik, Son, Ahn, Oh, Lee, Lee, Chung, Choi, Choi, and Kim: Current Status of Diabetic End-Stage Renal Disease Using Korean Health Insurance Database
Original Article
The Journal of Korean Diabetes Association

The Journal of Korean Diabetes Association 2006; 30(5): 355-362.

Published online: 30 September 2006

DOI: https://doi.org/10.4093/jkda.2006.30.5.355

Current Status of Diabetic End-Stage Renal Disease Using Korean Health Insurance Database

Dae Jung Kim*, , Jaiyong Kim*, **, Hyeyoung Kim**, Kyung Wan Min*, 1, Seok Won Park*, 2, Ie Byung Park*, 3, Jeong Hyun Park*, 4, Sei Hyun Baik*, 5, Hyun Shik Son*, 6, Chul Woo Ahn*, 7, Jee-Young Oh*, 8, Sunhee Lee**, Juneyoung Lee*, 9, Choon Hee Chung*, 10, Kyung Mook Choi*, 5, Injeoung Choi**, Hwayoung Kim*, **

*Task Force Team for Basic Statistical Study of Korean Diabetes Mellitus of Korean Diabetes Association, Korea.

**Department of Research, Health Insurance Review Agency, Korea.

Department of Endocrinology and Metabolism, Ajou University School of Medicine, Korea.

1Department of Internal Medicine, College of Medicine, Eulji University, Korea.

2Department of Internal, Pochon CHA University, Korea.

3Department of Endocrinology, Gachon University of Science and Medicine, Gil Medical Center, Korea.

4Pusan Paik Hospital, Inje College of Medicine, Korea.

5Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University, Korea.

6Department of Internal Medicine, The Catholic University, Korea.

7Department of Internal Medicine, Yonsei University College of Medicine, Korea.

8Division of Endocrinology and Metabolism, Department of Internal Medicine, Ewha Womans University College of Medicine, Korea.

9Department of Biostatistics, College of Medicine, Korea University, Korea.

10Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Korea.

Received 31 July 2006       Accepted 28 September 2006

Copyright © 2006 Korean Diabetes Association

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

Figures and Tables

Table 1
Clinical Characteristics of Prevalent End-Stage Renal Disease Patients
jkda-30-355-i001

Data are n or %. DM, diabetes mellitus; OHA, oral hypoglycemic agents; INS, insulin; HTN, anti-hypertensive agents; RRT, renal replacement therapy; HD, hemodialysis; PD, peritoneal dialysis; KT, kidney transplantation.

Table 2
Clinical Characteristics of Incident End-Stage Renal Disease Patients
jkda-30-355-i002

Data are n or %. DM, diabetes mellitus; RRT, renal replacement therapy; HD, hemodialysis; PD, peritoneal dialysis; KT, kidney transplantation.

Table 3
Clinical Characteristics of End-Stage Renal Disease Patients with and without Diabetes Mellitus in 2003
jkda-30-355-i003

Data are n or %. DM, diabetes mellitus; OHA, oral hypoglycemic agents; INS, insulin; HTN, anti-hypertensive agents.

Table 4
Annual Medical Costs of End-Stage Renal Disease Patients in 2003
jkda-30-355-i004

Data are n or %. DM; diabetes mellitus.

*Unit of cost: Won.

**comparison between non-diabetic and diabetic group.

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