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What is the impact of chronic kidney disease stage and cardiovascular disease on the annual cost of hospital care in moderate-to-severe kidney disease?

Kent, Seamus, Schlackow, Iryna, Lozano-Kühne, Jingky, Reith, Christina, Emberson, Joanthan, Haynes, Richard, Gray, Alastair, Cass, Alan, Baigent, Colin, Landray, Martin J., Herrington, William, Mihaylova, Borislava and SHARP Collaborative Group (2015). What is the impact of chronic kidney disease stage and cardiovascular disease on the annual cost of hospital care in moderate-to-severe kidney disease?. BMC Nephrology,16(Article No. 65).

Document type: Journal Article
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IRMA ID 75039815xPUB862
Title What is the impact of chronic kidney disease stage and cardiovascular disease on the annual cost of hospital care in moderate-to-severe kidney disease?
Author Kent, Seamus
Schlackow, Iryna
Lozano-Kühne, Jingky
Reith, Christina
Emberson, Joanthan
Haynes, Richard
Gray, Alastair
Cass, Alan
Baigent, Colin
Landray, Martin J.
Herrington, William
Mihaylova, Borislava
SHARP Collaborative Group
Journal Name BMC Nephrology
Publication Date 2015
Volume Number 16
Issue Number Article No. 65
ISSN 1471-2369   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84928897701
Total Pages 8
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Reliable estimates of the impacts of chronic kidney disease (CKD) stage, with and without cardiovascular disease, on hospital costs are needed to inform health policy.

Methods
The Study of Heart and Renal Protection (SHARP) randomized trial prospectively collected information on kidney disease progression, serious adverse events and hospital care use in a cohort of patients with moderate-to-severe CKD. In a secondary analysis of SHARP data, the impact of participants’ CKD stage, non-fatal cardiovascular events and deaths on annual hospital costs (i.e. all hospital admissions, routine dialysis treatments and recorded outpatient/day-case attendances in United Kingdom 2011 prices) were estimated using linear regression.

Results
7,246 SHARP patients (2,498 on dialysis at baseline) from Europe, North America, and Australasia contributed 28,261 years of data. CKD patients without diabetes or vascular disease incurred annual hospital care costs ranging from £403 (95% confidence interval: 345-462) in CKD stages 1-3B to £525 (449-602) in CKD stage 5 (not on dialysis). Patients in receipt of maintenance dialysis incurred annual hospital costs of £18,986 (18,620-19,352) in the year of initiation and £23,326 (23,231-23,421) annually thereafter. Patients with a functioning kidney transplant incurred £24,602 (24,027-25,178) in hospital care costs in the year of transplantation and £1,148 (978-1,318) annually thereafter. Non-fatal major vascular events increased annual costs in the year of the event by £6,133 (5,608-6,658) for patients on dialysis and by £4,350 (3,819-4,880) for patients not on dialysis, and were associated with increased costs, though to a lesser extent, in subsequent years.

Conclusions
Renal replacement therapy and major vascular events are the main contributors to the high hospital care costs in moderate-to-severe CKD. These estimates of hospital costs can be used to inform health policy in moderate-to-severe CKD.
Keywords Cardiovascular event
Chronic kidney disease
Annual hopital costs
Renal replacement therapy
DOI http://dx.doi.org/10.1186/s12882-015-0054-0   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License
URL https://creativecommons.org/licenses/by/4.0/au


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