scholarly journals Chronic kidney disease in Spain: analysis of patient characteristics, incidence and direct medical costs (2011–2017)

2020 ◽  
pp. 1-7
Author(s):  
Josep Darbà ◽  
Alicia Marsà
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Patient Characteristics ◽  
Medical Costs ◽  
Direct Medical Costs

scholarly journals Medical Costs Associated with Severity of Chronic Kidney Disease in Type 2 Diabetes Mellitus in Singapore

2020 ◽  
Vol 49 (10) ◽  
pp. 731-741
Author(s):  
Gwyneth J Lim ◽  
Yan Lun Liu ◽  
Serena Low ◽  
Keven Ang ◽  
Subramaniam Tavintharan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Medical Costs ◽  
Direct Medical Costs ◽  
Disease Costs ◽  
The Impact

Introduction: This was a retrospective cross-sectional study to assess the impact of chronic kidney disease (CKD) and its severity in Type 2 diabetes mellitus (T2DM) on direct medical costs, and the effects of economic burden on CKD related complications in T2DM in Singapore. Methods: A total of 1,275 T2DM patients were recruited by the diabetes centre at Khoo Teck Puat Hospital from 2011–2014. CKD stages were classified based on improving global outcome (KDIGO) categories, namely the estimated glomerular filtration rate (eGFR) and albuminuria kidney disease. Medical costs were extracted from the hospital administrative database. Results: CKD occurred in 57.3% of patients. The total mean cost ratio for CKD relative to non-CKD was 2.2 (P<0.001). Mean (median) baseline annual unadjusted costs were significantly higher with increasing CKD severity—S$1,523 (S$949), S$2,065 (S$1,198), S$3,502 (S$1,613), and S$5,328 (S$2,556) for low, moderate, high, and very high risk respectively (P<0.001). CKD (P<0.001), age at study entry (P=0.001), Malay ethnicity (P=0.035), duration of diabetes mellitus (DM; P<0.001), use of statins/fibrates (P=0.021), and modified Diabetes Complications Severity Index (DCSI) (P<0.001) were positively associated with mean annual direct medical costs in the univariate analysis. In the fully adjusted model, association with mean annual total costs persisted for CKD, CKD severity and modified DCSI. Conclusion: The presence and increased severity of CKD is significantly associated with higher direct medical costs in T2DM patients. Actively preventing the occurrence and progression in DM-induced CKD may significantly reduce healthcare resource consumption and healthcare costs. Keywords: Chronic kidney disease, costs, endocrinology, nephrology

scholarly journals The impact of cardiovascular disease and chronic kidney disease on life expectancy and direct medical cost in a 10-year diabetes cohort study

2020 ◽  
Author(s):  
Eric Yuk Fai Wan ◽  
Weng Yee Chin ◽  
Esther Yee Tak Yu ◽  
Ian Chi Kei Wong ◽  
Esther Wai Yin Chan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Kidney Disease ◽  
Life Expectancy ◽  
Medical Cost ◽  
Medical Costs ◽  
Mortality Risks ◽  
Direct Medical Costs ◽  
Patients With Diabetes

<b>Objective</b> <p>The relative effects of various cardiovascular diseases (CVD) and varying severity of chronic kidney disease (CKD) on mortality risk, direct medical cost and life expectancy in patients with diabetes mellitus (DM) are unclear. The aim of this study was to evaluate these associations. </p> <p> </p> <p><b>Research Design and Methods <br> </b>This was a retrospective cohort study that included 208,792 adults with diabetes stratified into 12 disease status groups with varying combinations of heart disease, stroke, moderate CKD (eGFR:30-59ml/min/1.73m<sup>2</sup>) and severe CKD (eGFR: <30ml/min/1.73m<sup>2</sup>) in 2008-2010. The effect of risk mortality, annual direct medical costs and life expectancy were assessed using Cox regression, <a></a><a></a><a>Gamma generalized linear with log link function</a>, and flexible parametric survival models. </p> <p> </p> <p><b>Results</b></p> <p>Over a median follow-up of 8.5 years (1.6 million patient-years), 50,154 deaths were recorded. Mortality risks for patients with only a single condition among heart disease, stroke and moderate CKD were similar. The mortality risks were 1.75 times, 2.63 times and 3.58 times greater for patients with one, two and all three conditions (consisting of stroke, heart disease and moderate CKD), compared with patients without these diseases, suggesting an independent and individually additive effect for any combination. A similar trend was observed in annual public healthcare costs with 2.91, 3.90 and 3.88 fold increased costs for patients with one, two and three conditions, respectively. Increases in the number of conditions reduced life expectancy greatly, particularly in younger patients. Reduction in life expectancy for a 40-year-old with one, two and three conditions were 20, 25, 30 years for men and 25, 30, 35 years for women. A similar trend of greater magnitude was observed for severe CKD.</p> <p> </p> <p><b>Conclusion</b></p> <p>The effect of heart diseases, stroke, CKD and the combination of these conditions on all-cause mortality and direct medical costs are independent and cumulative. CKD, especially severe CKD, appears to have a particularly significant impact on life expectancy and direct medical costs in patients with diabetes. These finding supports the importance of preventing both CVD and CKD in patients with DM.</p>

scholarly journals The impact of cardiovascular disease and chronic kidney disease on life expectancy and direct medical cost in a 10-year diabetes cohort study

2020 ◽  
Author(s):  
Eric Yuk Fai Wan ◽  
Weng Yee Chin ◽  
Esther Yee Tak Yu ◽  
Ian Chi Kei Wong ◽  
Esther Wai Yin Chan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Heart Disease ◽  
Kidney Disease ◽  
Life Expectancy ◽  
Medical Cost ◽  
Medical Costs ◽  
Mortality Risks ◽  
Direct Medical Costs ◽  
Patients With Diabetes

<b>Objective</b> <p>The relative effects of various cardiovascular diseases (CVD) and varying severity of chronic kidney disease (CKD) on mortality risk, direct medical cost and life expectancy in patients with diabetes mellitus (DM) are unclear. The aim of this study was to evaluate these associations. </p> <p> </p> <p><b>Research Design and Methods <br> </b>This was a retrospective cohort study that included 208,792 adults with diabetes stratified into 12 disease status groups with varying combinations of heart disease, stroke, moderate CKD (eGFR:30-59ml/min/1.73m<sup>2</sup>) and severe CKD (eGFR: <30ml/min/1.73m<sup>2</sup>) in 2008-2010. The effect of risk mortality, annual direct medical costs and life expectancy were assessed using Cox regression, <a></a><a></a><a>Gamma generalized linear with log link function</a>, and flexible parametric survival models. </p> <p> </p> <p><b>Results</b></p> <p>Over a median follow-up of 8.5 years (1.6 million patient-years), 50,154 deaths were recorded. Mortality risks for patients with only a single condition among heart disease, stroke and moderate CKD were similar. The mortality risks were 1.75 times, 2.63 times and 3.58 times greater for patients with one, two and all three conditions (consisting of stroke, heart disease and moderate CKD), compared with patients without these diseases, suggesting an independent and individually additive effect for any combination. A similar trend was observed in annual public healthcare costs with 2.91, 3.90 and 3.88 fold increased costs for patients with one, two and three conditions, respectively. Increases in the number of conditions reduced life expectancy greatly, particularly in younger patients. Reduction in life expectancy for a 40-year-old with one, two and three conditions were 20, 25, 30 years for men and 25, 30, 35 years for women. A similar trend of greater magnitude was observed for severe CKD.</p> <p> </p> <p><b>Conclusion</b></p> <p>The effect of heart diseases, stroke, CKD and the combination of these conditions on all-cause mortality and direct medical costs are independent and cumulative. CKD, especially severe CKD, appears to have a particularly significant impact on life expectancy and direct medical costs in patients with diabetes. These finding supports the importance of preventing both CVD and CKD in patients with DM.</p>

998-P: REVEAL-CKD: Prevalence of and Patient Characteristics Associated with Undiagnosed Stage 3 Chronic Kidney Disease

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 998-P
Author(s):  
ALYSHAH ABDUL SULTAN ◽  
SALVATORE BARONE ◽  
SUPRIYA KUMAR ◽  
HUNGTA CHEN ◽  
KRISTER JÄRBRINK ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Patient Characteristics

scholarly journals Patient Characteristics and Outcomes of 11 721 Patients With Coronavirus Disease 2019 (COVID-19) Hospitalized Across the United States

2020 ◽  
Author(s):  
Michael W Fried ◽  
Julie M Crawford ◽  
Andrea R Mospan ◽  
Stephanie E Watkins ◽  
Breda Munoz ◽  
...  
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Mechanical Ventilation ◽  
Kidney Disease ◽  
Clinical Course ◽  
Patient Characteristics ◽  
The United States ◽  
Geographic Region ◽  
Hospitalized Patients

Abstract Background As coronavirus disease 2019 (COVID-19) disseminates throughout the United States, a better understanding of the patient characteristics associated with hospitalization, morbidity, and mortality in diverse geographic regions is essential. Methods Hospital chargemaster data on adult patients with COVID-19 admitted to 245 hospitals across 38 states between 15 February and 20 April 2020 were assessed. The clinical course from admission, through hospitalization, and to discharge or death was analyzed. Results A total of 11 721 patients were included (majority were &gt;60 years of age [59.9%] and male [53.4%]). Comorbidities included hypertension (46.7%), diabetes (27.8%), cardiovascular disease (18.6%), obesity (16.1%), and chronic kidney disease (12.2%). Mechanical ventilation was required by 1967 patients (16.8%). Mortality among hospitalized patients was 21.4% and increased to 70.5% among those on mechanical ventilation. Male sex, older age, obesity, geographic region, and the presence of chronic kidney disease or a preexisting cardiovascular disease were associated with increased odds of mechanical ventilation. All aforementioned risk factors, with the exception of obesity, were associated with increased odds of death (all P values &lt; .001). Many patients received investigational medications for treatment of COVID-19, including 48 patients on remdesivir and 4232 on hydroxychloroquine. Conclusions This large observational cohort describes the clinical course and identifies factors associated with the outcomes of hospitalized patients with COVID-19 across the United States. These data can inform strategies to prioritize prevention and treatment for this disease.

scholarly journals Medical Costs of Untreated Anemia in Elderly Patients with Predialysis Chronic Kidney Disease

2006 ◽  
Vol 17 (12) ◽  
pp. 3497-3502 ◽  
Author(s):  
Patrick Lefebvre ◽  
Mei Sheng Duh ◽  
Sharon Buteau ◽  
Brahim Bookhart ◽  
Samir H. Mody
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Medical Costs

scholarly journals Prospects for improved glomerular filtration rate estimation based on creatinine—results from a transnational multicentre study

2020 ◽  
Vol 13 (4) ◽  
pp. 674-683 ◽  
Author(s):  
Jonas Björk ◽  
Ulf Nyman ◽  
Marie Courbebaisse ◽  
Lionel Couzi ◽  
R Neil Dalton ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Patient Characteristics ◽  
Cross Sectional ◽  
Disease Epidemiology ◽  
Gfr Estimation ◽  
Glomerular Filtration Rate Estimation

Abstract Background The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation is routinely used to assess renal function but exhibits varying accuracy depending on patient characteristics and clinical presentation. The overall aim of the present study was to assess if and to what extent glomerular filtration rate (GFR) estimation based on creatinine can be improved. Methods In a cross-sectional analysis covering the years 2003–17, CKD-EPI was validated against measured GFR (mGFR; using various tracer methods) in patients with high likelihood of chronic kidney disease (CKD; five CKD cohorts, n = 8365) and in patients with low likelihood of CKD (six community cohorts, n = 6759). Comparisons were made with the Lund–Malmö revised equation (LMR) and the Full Age Spectrum equation. Results 7In patients aged 18–39 years old, CKD-EPI overestimated GFR with 5.0–16 mL/min/1.73 m2 in median in both cohort types at mGFR levels &lt;120 mL/min/1.73 m2. LMR had greater accuracy than CKD-EPI in the CKD cohorts (P30, the percentage of estimated GFR within 30% of mGFR, 83.5% versus 76.6%). CKD-EPI was generally the most accurate equation in the community cohorts, but all three equations reached P30 above the Kidney Disease Outcomes Quality Initiative benchmark of 90%. Conclusions None of the evaluated equations made optimal use of available data. Prospects for improved GFR estimation procedures based on creatinine exist, particularly in young adults and in settings where patients with suspected or manifest CKD are investigated.

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