Estimates of health utility scores in chronic kidney disease

2017 ◽  
Vol 49 (11) ◽  
pp. 2043-2049 ◽  
Author(s):  
Nigar Sekercioglu ◽  
Bryan Curtis ◽  
Sean Murphy ◽  
Gord Blackhouse ◽  
Brendan Barrett
BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024854
Author(s):  
Sanjeewa Kularatna ◽  
Sameera Senanayake ◽  
Nalika Gunawardena ◽  
Nicholas Graves

ObjectivesThe aim of this study was to compare utility weights of EuroQoL-five-dimension-3 levels (EQ-5D-3L) and Short-Form six-dimension (SF-6D) in a representative cohort of patients with chronic kidney disease (CKD). A cost–utility analysis (CUA) is designed to report the change to costs required to achieve an estimated change to quality-adjusted life years (QALYs). The quality component of a QALY is measured by utility. Utility represents the preference of general population for a given health state. Classification systems of the multi-attribute utility instruments (MAUIs) are used to define these health states. Utility weights developed from different classification systems can vary and may affect the conclusions from CUAs.DesignA community-based cross-sectional study.SettingAnuradhapura, a rural district in Sri Lanka.ParticipantsA representative sample of 1096 patients with CKD, selected using the population-based CKD register, completed the EQ-5D-3L and SF-36. SF-6D was constructed from the SF-36 according to the published algorithm. The study assessed discrimination, correlation and differences across the two instruments.ResultsStudy participants were predominantly male (62.6%). Mean EQ-5D-3L utility score was 0.540 (SD 0.35) compared with 0.534 (SD 0.09) for the SF-6D (p=0.588). The correlation (r) between the scores was 0.40 (p<0.001). Utility scores were significantly different in both males and females between the two tools, but there was no difference in age and educational categories. Both MAUI scores were significantly lower (p<0.001) among those who were in more advanced stages of the disease and the corresponding utility scores of the two instruments in different CKD stages were also significantly different (p<0.05). The largest effect size was seen among the patients on dialysis.ConclusionsThe correlation between the scores was moderate. SF-6D had the lowest floor and ceiling effect and was better at detecting different stages of the disease. Thus, based on the evidence presented in this study, SF-6D appears to be more appropriate to be used among patients with CKD.


Author(s):  
Jiwoon Kim ◽  
Ji Sun Nam ◽  
Heejung Kim ◽  
Hye Sun Lee ◽  
Jung Eun Lee

Abstract. Background/Aims: Trials on the effects of cholecalciferol supplementation in type 2 diabetes with chronic kidney disease patients were underexplored. Therefore, the aim of this study was to investigate the effects of two different doses of vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D] concentrations and metabolic parameters in vitamin D-deficient Korean diabetes patients with chronic kidney disease. Methods: 92 patients completed this study: the placebo group (A, n = 33), the oral cholecalciferol 1,000 IU/day group (B, n = 34), or the single 200,000 IU injection group (C, n = 25, equivalent to 2,000 IU/day). 52% of the patients had less than 60 mL/min/1.73m2 of glomerular filtration rates. Laboratory test and pulse wave velocity were performed before and after supplementation. Results: After 12 weeks, serum 25(OH)D concentrations of the patients who received vitamin D supplementation were significantly increased (A, -2.4 ± 1.2 ng/mL vs. B, 10.7 ± 1.2 ng/mL vs. C, 14.6 ± 1.7 ng/mL; p < 0.001). In addition, the lipid profiles in the vitamin D injection group (C) showed a significant decrease in triglyceride and a rise in HDL cholesterol. However, the other parameters showed no differences. Conclusions: Our data indicated that two different doses and routes of vitamin D administration significantly and safely increased serum 25(OH)D concentrations in vitamin D-deficient diabetes patients with comorbid chronic kidney disease. In the group that received the higher vitamin D dose, the lipid profiles showed significant improvement, but there were no beneficial effects on other metabolic parameters.


VASA ◽  
2012 ◽  
Vol 41 (3) ◽  
pp. 159-160
Author(s):  
Espinola-Klein ◽  
F. Dopheide ◽  
Gori

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