Supplementary Material for: Impact of Renal Disease on Patients with Hepatitis C: A Retrospective Analysis of Disease Burden, Clinical Outcomes, and Health Care Utilization and Cost

<b><i>Background/Aims:</i></b> Few studies explore the magnitude of the disease burden and health care utilization imposed by renal disease among patients with hepatitis C virus (HCV). We aimed to describe the characteristics, outcomes, and health care utilization and costs of patients with HCV with and without renal impairment. <b><i>Methods:</i></b> This retrospective analysis used 2 administrative claims databases: the US commercially insured population in Truven Health MarketScan® data (aged 20-64 years), and the US Medicare fee-for-service population in the Medicare 20% sample (aged ≥65 years). Baseline characteristics and comorbid conditions were identified from claims during 2011; patients were followed for up to 1 year (beginning January 1, 2012) to identify health outcomes of interest and health care utilization and costs. <b><i>Results:</i></b> In the MarketScan and Medicare databases, 35,965 and 10,608 patients with HCV were identified, 8.5 and 26.5% with evidence of renal disease (chronic kidney disease [CKD] or end-stage renal disease [ESRD]). Most comorbid conditions and unadjusted outcome rates increased across groups from patients with no evidence of renal disease to non-ESRD CKD to ESRD. Health care utilization followed a similar pattern, as did the costs. <b><i>Conclusions:</i></b> Our findings suggest that HCV patients with concurrent renal disease have significantly more comorbidity, a higher likelihood of negative health outcomes, and higher health care utilization and costs.

**背景与目的：** 目前鲜有研究探讨丙型肝炎病毒（hepatitis C virus, HCV）感染者罹患肾脏疾病所带来的疾病负担规模与医疗资源利用情况。本研究旨在描述合并与未合并肾功能损害的HCV感染者的临床特征、健康转归、医疗资源利用情况及相关成本。
**方法：** 本回顾性分析采用了两项行政索赔数据库：一是Truven Health MarketScan®数据库中的美国商业保险参保人群（年龄20~64岁），二是美国医疗保险20%抽样样本中的按服务付费参保人群（年龄≥65岁）。基线特征与合并症通过2011年的索赔数据进行识别；研究对象自2012年1月1日起被随访长达1年，以明确目标健康结局、医疗资源利用情况及相关成本。
**结果：** 在MarketScan与Medicare数据库中，分别识别出35965例与10608例HCV感染者，其中8.5%与26.5%存在肾脏疾病证据（慢性肾脏病，chronic kidney disease, CKD；终末期肾病，end-stage renal disease, ESRD）。从无肾脏疾病证据者、非终末期肾病CKD患者至终末期肾病ESRD患者，绝大多数合并症与未校正结局发生率均呈逐步升高趋势。医疗资源利用情况与相关成本亦呈现相似的变化模式。
**结论：** 本研究结果显示，合并肾脏疾病的HCV感染者合并症负担更重，不良健康结局发生风险更高，医疗资源利用程度与相关成本亦显著更高。