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Trends in Prevalence of Polycystic Kidney Disease Among Medicare Beneficiaries

The percentage of Medicare Fee-for-Service beneficiaries aged 65 years and older with polycystic kidney disease (PKD) over time has remained low and mostly flat between 2016 and 2021. A higher prevalence of PKD was seen among adults 65–69 years of age, non-Hispanic Black persons, males, and those with diabetes, hypertension, or stage 5 CKD. Crude and age-standardized trends were consistent.

Data Source: Medicare

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Trends in Prevalence of Polycystic Kidney Disease Among Medicare Beneficiaries by Overall (%) Medicare 5% random sample
2016	2017	2018	2019	2020	2021
0.1 (95% CI: 0.1-0.1)	0.1 (95% CI: 0.1-0.1)	0.1 (95% CI: 0.1-0.1)	0.1 (95% CI: 0.1-0.1)	0.1 (95% CI: 0.1-0.1)	0.1 (95% CI: 0.1-0.1)

Trends in Prevalence of Polycystic Kidney Disease Among Medicare Beneficiaries by Overall (%) Medicare 5% random sample
2016	2017	2018	2019	2020	2021
0	0	0	0	0	0

Age-standardized estimates were standardized to the 2018 Medicare Fee-for-Service population for adults aged 65 years and older.

CMS maintains claims data on beneficiaries aged 65 years and older, those with disabilities, and those with end-stage kidney disease. A 5% random sample of beneficiaries who had at least one inpatient or outpatient visit during the calendar year—over 1.8 million annually—of Medicare claims data was used.

Diagnoses for medical conditions in Medicare data come from claims submitted by providers for Medicare fee-for-service Part A (hospital insurance) and Part B (medical insurance). The analysis sample was limited to beneficiaries aged 65 years or older who had Parts A and B coverage for the entire calendar year and had at least one inpatient or outpatient visit in that calendar year. Between 20% and 37% of beneficiaries each year used Part C (managed care/Medicare Advantage plans) and are excluded because their care was paid on fixed amount and claims with diagnoses are unavailable. Chronic kidney disease, diabetes, and hypertension are defined by at least one diagnosis code for each condition.

Field	Data
Description of Measure	Prevalence of Polycystic Kidney Disease (PKD) among Medicare Beneficiaries.
Data Set	Medicare 5% random sample.
Population	Medicare Fee-For-Service beneficiaries aged ≥ 65 years.
Years Included	2016–2021.
Definition of Polycystic Kidney Disease	Polycystic kidney disease (PKD) is defined by ICD-10-CM codes Q612 (polycystic kidney disease, autosomal dominant) and Q613 (polycystic kidney disease, unspecified).
Numerator	Medicare Fee-For-Service beneficiaries aged ≥ 65 years with diagnosed PKD from claims by any of the ICD-10-CM PKD codes.
Denominator	For each reporting year, Medicare enrollees aged 65 years and older were included. Medical history was assessed from claims using any of the ICD-9-CM code and ICD-10-CM codes listed below.
ICD-10-CM Codes for CKD	A18.11, A52.75, B52.0, C64.x, C68.9, D30.0x, D41.0x-D41.2x, D59.3, E08.2x, E09.2x, E10.2x, E10.65, E11.2x, E11.65, E13.2x, E74.8, I12.xx, I13.0, I13.1x, I13.2, K76.7, M10.3x, M32.14, M32.15, N01.x-N08.x, N13.1, N13.1x-N13.39, N14.x,N15.0, N15.8, N15.9, N16, N17.x, N18.1-N18.5, N18.8, N18.9, N19, N25.xx, N26.1, N26.9, O10.4xx, O12.xx, O26.83x, O90.89, Q61.02, Q61.1x-Q61.8, Q26.0-Q26.39, R94.4 (x and xx stand for all the codes within the main diagnosis).
ICD-9-CM Codes for CKD	016.0, 095.4, 189.0,189.1, 189.9, 236.91, 250.4, 250.41, 250.42, 250.43, 271.4, 274.10, 283.11, 403.xx, 404.xx, 405.01, 405.11, 440.1, 442.1, 447.3, 453.3, 573.4, 580.xx, 581.xx, 582.xx, 583.xx, 584.5, 585.x, 587.xx, 588.xx, 590.xx, 591, 592.x, 593.xx, 642.1, 646.2, 753.xx, 794.4.
Definition of CKD	CKD is defined by an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² or albuminuria (urine albumin to creatinine ratio [UACR] ≥ 30 mg/g). Stage 1: eGFR ≥90 ml/min/1.73 m² and albuminuria; stage 2: eGFR 60–89 ml/min/1.73 m² and albuminuria; stage 3a: eGFR 45–59 ml/min/1.73 m²; stage 3b: eGFR 30–44 ml/min/1.73 m²; stage 4: 15–29 ml/min/1.73 m²; stage 5: eGFR <15 ml/min/1.73 m². Estimates are based on single estimates of eGFR and UACR.
Diabetes	Diabetes is determined by the presence of an ICD-9-CM code (250.xx, 357.2, 336.41, 362.01, 362.02) or ICD-10-CM code (E08.xx, E09.xx, E10.xx, E11.xx, E13.xx) on at least one claim during the given calendar year.
Hypertension	Hypertension is determined by the presence of an ICD-9-CM code (401.x through 405.x) or ICD-10-CM code (H35.03x, I10.xx, I11.xx, I12.xx, I13.xx, I15.xxx, I67.4, N26.2) on at least one claim during the given calendar year.
Age Standardization	Estimates were standardized to the 2018 Medicare Fee-for-Service population for adults aged 65 years and older: 65–69 years (31.46%), 70–79 years (43.75%), 80–89 years (20.08%), and 90+ years (4.71%).
Limitations of Indicator	PKD is captured by ICD diagnosis codes from the claims data, and does not include results from imaging tests, genetic testing, or laboratory evaluation.
Analytical Considerations	Survival bias is likely as beneficiaries must still be alive at 65 years old for these analyses. For PKD, it should be noted that ascertainment using claims data can be low.