The estimated costs associated with new cases of chronic kidney disease in Catalonia increased from € 3.66 million to € 4.61 million between 2014 and 2021, representing a 26 % increase. This is the main conclusion of a study coordinated by a research team from IDIAPJGol, recently published in the European Journal of Health Economics, which analysed data from more than 400,000 people diagnosed with the disease in Catalonia and assessed healthcare resource use during this period.
Half of the recorded expenditure was attributable to hospitalisations, which increased by 17 %, mainly due to longer hospital stays. Primary care visits were the second most important cost factor, although costs in this area decreased by more than 9 % during the period, mainly due to changes in the type of visits and healthcare professionals involved, with greater involvement of nurses. Costs associated with renal replacement therapies, including transplants and dialysis, increased by 157 %.
In addition, indirect costs associated with sick leave more than doubled, rising from € 324,770 in 2014 to € 680,672 in 2021. The increase in sick leave was particularly sharp in 2020 and 2021, coinciding with the COVID-19 pandemic, reflecting the loss of productivity during this period among people with chronic diseases.
Increase in hospital admissions related to kidney disease
The number of hospital admissions for any cause remained stable over time, but an increase was detected in the number of hospitalisation days per 1,000 patients/year, which rose by 13 % between 2012 and 2022, reflecting greater complexity. Cardiovascular diseases, particularly heart failure, were the main causes of hospital admission, although their relative contribution decreased slightly between 2012 and 2022, falling from 16.7 % to 13 %. By contrast, the number of admissions associated with kidney disease and hospital stays more than doubled between 2017 and 2022.
Thus, hospitalisations were the main cost factor, accounting for more than half of total expenditure, although their relative share decreased slightly between 2014 and 2021 (from 55.2 % to 51.3 %). Heart failure was the main cause of hospitalisation costs, accounting for 40 % of admissions for cardiovascular or renal causes. However, hospitalisations specifically related to chronic kidney disease increased significantly from 2017 onwards and by 2021 accounted for 25.9 % of hospitalisation costs associated jointly with cardiovascular diseases and chronic kidney disease.
As for primary care visits, which decreased overall during the study period, there was a decrease in visits to physicians and an increase in nursing visits.
SIDIAP data
For the study, the research team analysed data from 447,202 people with a new diagnosis of chronic kidney disease identified during the 2021–2022 period in the Information System for Research in Primary Care (SIDIAP), which collects anonymised information on people treated at almost 80 % of primary care centres in Catalonia.
Oriol Cunillera Puértolas, a researcher at the Metropolitan South Research Support Unit (USR) of IDIAPJGol and the Institut Català de la Salut, and first author of the study, highlights that the findings reflect “the cumulative impact of disease progression and changes in its management”.
Meanwhile, Betlem Salvador González, head of the Metropolitan South USR and coordinator of the research, points out that “improving the early detection and management of chronic kidney disease in primary care, as well as coordination between different levels of care, can help prevent and slow its progression and the complications it causes and, therefore, reduce its clinical and economic burden”.
The study was funded by and conducted with the participation of pharmaceutical company Boehringer Ingelheim.
Article reference
Cunillera-Puértolas O, Casajuana M, Arbiol-Roca A, Romano-Sánchez J, Jiménez-Martín N, Bundó-Luque D, Cobo-Guerrero S, Blasco-Duatis M, Solé A, López A, Domínguez-Alonso A, Salvador-González B. Temporal trends in healthcare resource use and costs of chronic kidney disease in a Spanish population: the REDIC study. Eur J Health Econ. 2026 May 19. doi: 10.1007/s10198-026-01922-7. Epub ahead of print. PMID: 42154360.
