Journal article
Kidney Imaging Surveillance in Commercially Insured Patients With Tuberous Sclerosis Complex
Pediatric neurology, Vol.117, pp.21-26
04/2021
DOI: 10.1016/j.pediatrneurol.2020.12.008
PMID: 33647778
Abstract
Kidney disease has historically been the primary source of early mortality in adults with tuberous sclerosis complex (TSC). Kidney imaging surveillance promotes early detection of lesions requiring intervention. We describe kidney imaging frequency in relationship to patient-level characteristics for commercially insured patients with TSC in the United States.
This retrospective observational study used 2003 to 2016 enrollment and claims data from a de-identified fully insured commercial health insurer. Patients with TSC less than 65 years were included. The patient-level kidney imaging rate was calculated as the number of kidney imaging procedures divided by length of continuous enrollment. A multiple linear regression model was used to determine the relationship between imaging rate and progression of TSC-associated kidney disease, number of specialists seen, and nephrologist care.
At least half of the 70 patients with TSC included in the study were aged 16 years or younger. Over a follow-up period of up to 14 years, the median kidney imaging rate was 0.13 procedures per year with 43% (N = 30) of patients lacking evidence of kidney imaging during the observation period. Imaging frequency increased with progression of TSC-associated kidney disease, more specialists, and nephrologist care (P < 0.05 for all three in regression model).
A substantial percentage of patients with TSC in the United States are at risk for delayed detection of kidney manifestations due to infrequent kidney imaging surveillance. Multispecialty care, including neurologists, may positively affect kidney surveillance rates.
Details
- Title: Subtitle
- Kidney Imaging Surveillance in Commercially Insured Patients With Tuberous Sclerosis Complex
- Creators
- Amber M Goedken - Division of Health Services Research, College of Pharmacy, University of Iowa, Iowa City, IowaJoshua A Samuels - Division of Pediatric Nephrology and Hypertension, McGovern Medical School, University of Texas Health Science Center, Houston, TexasTakashi S Sato - Division of Pediatric Radiology, Stead Family Children’s Hospital, University of Iowa, Iowa City, IowaLyndsay A Harshman - Division of Pediatric Nephrology, University of Iowa Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Pediatric neurology, Vol.117, pp.21-26
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.pediatrneurol.2020.12.008
- PMID
- 33647778
- ISSN
- 0887-8994
- eISSN
- 1873-5150
- Language
- English
- Date published
- 04/2021
- Academic Unit
- Radiology; Pharmacy; Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Radiation Oncology; Pharmacy Practice and Science
- Record Identifier
- 9984070152302771
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