Background:
chronic diseases represent significant economic costs for health systems. The study of the costs associated with the care of these diseases helps to develop strategies to reduce the economic impact of these pathologies

Objective:
To estimate the incidence and direct cost of care for chronic kidney disease (CKD) in patients with type 2 diabetes.

Methods:
A survival analysis was performed with the Kaplan-Meier estimator, where the probability of the appearance of CKD is estimated. Direct costs were estimated in a cohort of 34,444 patients with type 2 diabetes mellitus over 4 years. The data on the costs were extracted from the database of patients registered with a health insurance company. A Markov chain model was built to measure the economic impact of the disease.

Results:
66% of the patients in the cohort are women. The average age of the patients is 59.4 years (SD = 12.5). CKD survival in the study cohort was 66%. The mean cost of patients with type 2 diabetes mellitus with CKD was US$ 28,116 [US$ 21,403 – US$ 34,828]. Regarding chronic kidney disease transition costs, it is estimated that the discounted direct costs of care for the simulated cohort ranged from US$ 62,599,647 to US$ 190,157,827. However, by stages of CKD, the most expensive stage in average terms was CKD3b, where a higher prevalence of patients is recurrent in these stages.

Conclusions:
The progression from diabetes mellitus to chronic kidney disease generates an escalation of costs that affects the health system.