Chronic kidney disease in Spain: Prevalence and impact of accumulation of cardiovascular risk factors

Gorostidi, Manuel; Sánchez-Martínez, Mercedes; Ruilope, Luis; Graciani, Auxiliadora; Cruz, Juan; Santamaría, Rafael; Pino, María Dolores del Pino y; Guallar‐Castillón, Pilar; Álvaro, Fernando de; Rodríguez‐Artalejo, Fernando; Banegas, José R.

doi:10.1016/j.nefroe.2018.04.010

Cited by 43 publications

(46 citation statements)

References 20 publications

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“…In terms of mortality, kidney diseases were the 12th cause of death worldwide in 2016, and the percentage of all deaths attributable to CKD globally was estimated to increase 33.7% between 2007 and 2017, when it caused over 1.2 million deaths 5,6 . In Spain, the prevalence of CKD remains around 15%, although in males it is estimated to reach 23%, and mortality rates are similar to global estimations 7,8 .…”

Section: Introductionsupporting

confidence: 55%

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

Darbà

Marsà²

2020

Journal of Medical Economics

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Objectives: To review the characteristics of patients with chronic kidney disease (CKD) who attended primary and specialized care centers in Spain, and to analyze patients' use of medical resources and direct medical costs of specialized care. Methods: Records of patients with CKD admitted to primary and specialized healthcare centers in Spain between 2011 and 2017 from two national discharge databases were analyzed in a retrospective multicenter observational study. Records were classified into one-to-five CKD stages plus a 5b stage, indicating end-stage renal disease. Results: Most of the patients registered in hospital settings were in stage 5. Registered secondary conditions included hypertensive chronic kidney, diabetes, anemia, hypercholesterolemia, and hypertension. The number of cases registered in primary care settings increased over time, whereas in specialized care centers incidence decreased; hospital incidence of CKD in 2017 was 10.72 per 10,000 persons. Mean in-hospital mortality was 5.90%, which remained stable during the study period. Mortality was associated with respiratory and heart failure. Mean length of hospital stay was 8.19 days, decreasing over the study period, whilst increasing with CKD progression. Mean annual direct medical cost of specialized care was e10,436 per patient. Complications of a transplant and bacterial infections were responsible for major increases in medical costs, that otherwise decreased over the study period. Conclusions: The costs of specialized care decreased with the length of hospital stay reduction. Cardiovascular risk factors were crucial in in-hospital mortality. This study provides population-based data to assist decision-makers at the national level and to contribute to worldwide evaluations and disease surveillance.

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Section: Introductionsupporting

confidence: 55%

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

Darbà

Marsà²

2020

Journal of Medical Economics

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“…Since this is database study, patients with CKD risk factors (such as diabetes mellitus, hypertension or cardiovascular disease, who are not regularly screened and therefore identified) cannot be reflected, showing the high underdiagnosis rate of CKD still present nowadays. Additionally, this difference in CKD prevalence might be a consequence of a higher use of CKD protective treatments [ 23 , 28 – 30 ]. Despite the fact that 71% of patients were taking RAAS inhibitors (82% among T2D patients) in our study, only 4.4% of patients reached maximal doses, suggesting that there is still a potential benefit on CKD outcomes with uptitration).…”

Section: Discussionmentioning

confidence: 99%

Costs and healthcare utilisation of patients with chronic kidney disease in Spain

Escobar

Palacios

Aranda

et al. 2021

BMC Health Serv Res

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Background Data about the impact of chronic kidney disease (CKD) on health care costs in Spain are scarce This study was aimed to evaluate cumulative costs and healthcare utilisation in CKD in Spain. Methods Observational, retrospective, population-based study, which included adults who received care for CKD between 2015 and 2019. Healthcare and medication costs were summarized on a yearly basis starting from the index date (1st January 2015), and then cumulatively until 2019. Results We identified 44,214 patients with CKD (year 2015: age 76.4 ± 14.3 years, 49.0% women, albumin-to-creatinine ratio 362.9 ± 176.8 mg/g, estimated glomerular filtration rate 48.7 ± 13.2 mL/min/1.73 m2). During the 2015–2019 period, cumulative CKD associated costs reached 14,728.4 Euros, being cardiovascular disease hospitalizations, particularly due to heart failure and CKD, responsible for 77.1% of costs. Total medication cost accounted for 6.6% of the total cost. There was a progressive decrease in cardiovascular disease hospital costs per year (from 2741.1 Euros in 2015 to 1.971.7 Euros in 2019). This also occurred with cardiovascular and diabetic medication costs, as well as with the proportion of hospitalizations and mortality. Costs and healthcare resources use were higher in the DAPA-CKD like population, but also decreased over time. Conclusions Between 2015 and 2019, costs of patients with CKD in Spain were high, with cardiovascular hospitalizations as the key determinant. Medication costs were responsible for only a small proportion of total CKD costs. Improving CKD management, particularly with the use of cardiovascular and renal protective medications may be helpful to reduce CKD burden.

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“…This disease does not only morphologically and functionally affect the kidneys, but also the patients’ biopsychosocial spheres, subjecting them to physical, psychological and socio-labor limitations [ 3 ] and increasing their end-of-life medicalization [ 4 ]. In addition to the aforementioned, they experience very stressful situations such as diagnosis acceptance, disease progression, choice of treatment options and coping with dialysis [ 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Suffering of Advanced Chronic Renal Patients and Their Relationship with Symptoms in Loja, Ecuador

Sierra

Vargas-Martínez

León-Larios

et al. 2021

IJERPH

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Advanced Chronic Kidney Disease (ACKD) supposes a public health problem in Ecuador that requires a comprehensive approach. In view of the scarcity of studies on the subject in this country, the objective of this research was to determine the signs and symptoms associated with the patients’ physical, social and psychological spheres that allow properly developing palliative care. A longitudinal, prospective and observational study was conducted with ACKD patients. In order to assess the symptomatic burden and suffering of these patients, the Edmonton Symptom Assessment System Revised: renal (ESAS-r) for renal patients and the Distress Thermometer (DT) were used. The sample consisted of a total of 246 patients. The most common symptoms that affect them, causing them suffering in their daily lives, are those related to well-being, difficulty falling asleep and itching. It is necessary that health professionals adapt care measures and help patients undergoing renal treatment, especially those who have suffered the disease for a longer period of time, in order to alleviate the patients’ suffering and therefore improve their daily lives. To such an end, a care plan could be designed that includes early palliative care.

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Chronic kidney disease in Spain: Prevalence and impact of accumulation of cardiovascular risk factors

Cited by 43 publications

References 20 publications

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

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

Costs and healthcare utilisation of patients with chronic kidney disease in Spain

The Suffering of Advanced Chronic Renal Patients and Their Relationship with Symptoms in Loja, Ecuador

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