Economic evaluation of different treatment modalities in acute kidney injury

被引:21
|
作者
De Smedt, Delphine M. [1 ]
Elseviers, Monique M. [2 ]
Lins, Robert L. [2 ]
Annemans, Lieven [1 ,3 ]
机构
[1] Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium
[2] Univ Antwerp, Dept Med, B-2020 Antwerp, Belgium
[3] Vrije Univ Brussel, Fac Med & Pharm, Brussels, Belgium
关键词
acute kidney injury; cost-effectiveness; renal replacement therapy; SHARF; RENAL REPLACEMENT THERAPY; CRITICALLY-ILL PATIENTS; INTENSIVE-CARE-UNIT; INTERMITTENT HEMODIALYSIS; COST-EFFECTIVENESS; SCORING SYSTEM; FAILURE; MORTALITY; DIALYSIS; HEALTH;
D O I
10.1093/ndt/gfs410
中图分类号
R3 [基础医学]; R4 [临床医学];
学科分类号
1001 ; 1002 ; 100602 ;
摘要
Major controversy exists regarding the preferred treatment option for acute kidney injury (AKI). The purpose of this study was to assess the incremental cost-effectiveness of continuousrenal replacement therapy (CRRT) versus intermittent renal replacement therapy (IRRT) and conservative (CONS) AKI treatment in Belgium. An area-under-the-curve model based on survival analysis was used to estimate costs and health outcomes using a 2-year time horizon. Input data were derived from the multi-centre Stuivenberg Hospital Acute Renal Failure 4 study. Analyses indicated that in-hospital mortality, hospitalization costs and hospital length of stay differed significantly between treatment modes. Follow-up mortality rates and follow-up cost per day showed no significant difference between the treatment modes. Utility values, which improved gradually after admission to the hospital, revealed no significant differences between the three treatment strategies. CONS treatment was associated with a 2-year cost of 33 802Euro and 0.54 quality-adjusted life years (QALYs). The CRRT was the most expensive therapy with a cost of 51 365Euro leading to 0.57 QALYs. The cost and QALYs associated with IRRT were 43 445Euro and 0.50, respectively. One-way sensitivity analyses indicated the oin-hospital mortality' as the variable with the greatest influence on the results. Probabilistic sensitivity analysis resulted in a significant difference in treatment costs but no significant difference in QALY gain. This study has indicated that the most expensive treatment (CRRT) associated with an incremental cost of approximately Euro7920 generates only a minor non-significant increase in QALYs of 0.07 compared with IRRT. Additionally, the results revealed that the RRTs did not result in a significant increase in QALYs despite their higher cost compared with the CONS treatment. From a health economic perspective, the latter seems to be the preferred treatment strategy.
引用
收藏
页码:4095 / 4101
页数:7
相关论文
共 50 条
  • [41] Clinical utility of ultrasonographic evaluation in acute kidney injury
    Liu, Caijie
    Wang, Xiuzhen
    TRANSLATIONAL ANDROLOGY AND UROLOGY, 2020, 9 (03) : 1345 - 1355
  • [42] Acute kidney injury (AKI)Acute kidney injury (AKI)
    Kai Schmidt-Ott
    Kirsten de Groot
    Kai Uwe Eckardt
    Die Nephrologie, 2024, 19 (3) : 127 - 128
  • [43] Application of carbon monoxide for treatment of acute kidney injury
    Nakao, Atsunori
    Yamada, Taihei
    Kohama, Keisuke
    Yoshie, Norichika
    Fujisaki, Noritomo
    Kotani, Joji
    ACUTE MEDICINE & SURGERY, 2014, 1 (03): : 127 - 134
  • [44] New trends in pharmacological treatment of acute kidney injury
    Heba M.I.Abdallah
    Asian Pacific Journal of Tropical Biomedicine, 2021, 11 (07) : 285 - 297
  • [45] Cardiovascular Consequences of Acute Kidney Injury: Treatment Options
    Voicehovska, Julija G.
    Trumpika, Dace
    Voicehovskis, Vladimirs V.
    Bormane, Eva
    Busmane, Inara
    Grigane, Anda
    Moreino, Eva
    Lejnieks, Aivars
    BIOMEDICINES, 2023, 11 (09)
  • [46] New trends in pharmacological treatment of acute kidney injury
    Abdallah, Heba
    ASIAN PACIFIC JOURNAL OF TROPICAL BIOMEDICINE, 2021, 11 (07) : 285 - 297
  • [47] Recent Advances in Nanomaterials for the Treatment of Acute Kidney Injury
    Ba, Xiaozhuo
    Ye, Tao
    Shang, Haojie
    Tong, Yonghua
    Huang, Qiu
    He, Yu
    Wu, Jian
    Deng, Wen
    Zhong, Zichen
    Yang, Xiaoqi
    Wang, Kangyang
    Xie, Yabin
    Zhang, Yanlong
    Guo, Xiaolin
    Tang, Kun
    ACS APPLIED MATERIALS & INTERFACES, 2024, 16 (10) : 12117 - 12148
  • [48] Dialytic Treatment for Septic Patients with Acute Kidney Injury
    Davenport, Andrew
    KIDNEY & BLOOD PRESSURE RESEARCH, 2011, 34 (04): : 218 - 224
  • [49] Ferroptosis: A new insight for treatment of acute kidney injury
    Li, Shiyang
    Wang, Rui
    Wang, Yixue
    Liu, Yong
    Qiao, Yingjin
    Li, Peipei
    Chen, Jingfang
    Pan, Shaokang
    Feng, Qi
    Liu, Zhangsuo
    Liu, Dongwei
    FRONTIERS IN PHARMACOLOGY, 2022, 13
  • [50] Treatment Algorithm for Acute Kidney Injury in Patients with Cirrhosis
    Song, Myeong Jun
    KOREAN JOURNAL OF GASTROENTEROLOGY, 2024, 84 (06): : 295 - 296