Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy

Wong, Carlos King Ho; Chen, Julie; Fung, Samuel; Mok, Maggie Ming Yee; Cheng, Yuk Lun; Kong, Irene; Lo, Wai Kei; Lui, Sing Leung; Chan, Tak Mao; Lam, Cindy L. K.

doi:10.1186/s12882-020-1708-0

Cited by 19 publications

(23 citation statements)

References 30 publications

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“…As a result, up to 75% of dialysis patients are on PD, which made Hong Kong the city with the largest PDto-HD patient ratio in the world. PD offers several advantages over HD, including a lower cost, a higher effectiveness of quality-adjusted life years, and less dialysis -associated infection and a better preservation of residual renal function [21][22][23]. PD patients in Hong Kong have a comparable survival rate to HD patients even in the elderly group [24,25].…”

Section: Hong Kongmentioning

confidence: 99%

Tackling Dialysis Burden around the World: A Global Challenge

Chan

Chen

et al. 2021

Kidney Dis

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CKD is a global problem that causes significant burden to the healthcare system and the economy in addition to its impact on morbidity and mortality of patients. Around the world, in both developing and developed economies, the nephrologists and governments face the challenges of the need to provide a quality and cost-effective kidney replacement therapy for CKD patients when their kidneys fail. In December 2019, the 3rd International Congress of Chinese Nephrologists was held in Nanjing, China, and in the meeting, a symposium and roundtable discussion on how to deal with this CKD burden was held with opinion leaders from countries and regions around the world, including Australia, Canada, China, Hong Kong, Singapore, Taiwan, the UK, and the USA. The participants concluded that an integrated approach with early detection of CKD, prompt treatment to slow down progression, promotion of home-based dialysis therapy like peritoneal dialysis and home HD, together with promotion of kidney transplantation, are possible effective ways to combat this ongoing worldwide challenge.

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Section: Hong Kongmentioning

confidence: 99%

Tackling Dialysis Burden around the World: A Global Challenge

Chan

Chen

et al. 2021

Kidney Dis

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“…The provision of hemodialysis following snakebites is a real challenge for low-income countries, such as Brazil, which are overburdened with patients requiring it. A recent study conducted in China has estimated that one hemodialysis session costs US$ 386.6 [ 46 ]. In Brazil, according to the Brazilian healthcare system ( Sistema Único de Saúde - SUS), a hemodialysis procedure costs US$ ~40 per session and US$ ~7,500 per patient per year [ 47 ], which is, however, covered by the government.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, depression, with a prevalence from 22.8% to 39.3%, is a very common psychological disease in patients who are dependent on hemodialysis, and this co-morbidity must be treated as well [ 48 ]. Renal transplantation is considered to be a cost-saving and preferable alternative for patients under hemodialysis, since a renal transplantation is estimated to cost US$ 10,279, which is at a similar cost level as one year of hemodialysis treatment [ 46 ]. However, due to scarcity of organ donations, it cannot be considered as an easily accessible alternative.…”

Section: Discussionmentioning

confidence: 99%

Chronic kidney failure following lancehead bite envenoming: a clinical report from the Amazon region

Pucca¹,

Franco²,

Medeiros³

et al. 2020

J. Venom. Anim. Toxins incl. Trop. Dis

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Background: Snakebite envenoming can be a life-threatening condition, for which emergency care is essential. The Bothrops (lancehead) genus is responsible for most snakebite-related deaths and permanent loss of function in human victims in Latin America. Bothrops spp. venom is a complex mixture of different proteins that are known to cause local necrosis, coagulopathy, and acute kidney injury. However, the long-term effects of these viper envenomings have remained largely understudied. Case presentation: Here, we present a case report of a 46-years old female patient from Las Claritas, Venezuela, who was envenomed by a snake from the Bothrops genus. The patient was followed for a 10-year period, during which she presented oliguric renal failure, culminating in kidney failure 60 months after the envenoming. Conclusion:In Latin America, especially in Brazil, where there is a high prevalence of Bothrops envenoming, it may be relevant to establish long-term outpatient programs. This would reduce late adverse events, such as chronic kidney disease, and optimize public financial resources by avoiding hemodialysis and consequently kidney transplantation.

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“…However, most of the studies evaluated parts of RRT modalities, such as comparing different dialysis modalities with one another or a certain dialysis modality with TX. [5][6][7] Several studies have assessed the cost-effectiveness of all available RRT modalities, but most of them were conducted in developed countries, such as the UK, 8 Japan, 9 Denmark 10 and Australia. 11 The majority of these studies suggest that TX is the optimal RRT modality and PD is more favourable than HD from the viewpoint of cost-effectiveness.…”

Section: Open Accessmentioning

confidence: 99%

Cost-effectiveness analysis of renal replacement therapy strategies in Guangzhou city, southern China

et al. 2021

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ObjectivesThis study aims to assess the cost-effectiveness of three renal replacement therapy (RRT) modalities as well as proposed changes of scheduled policies in RRT composition in Guangzhou city.MethodsFrom a payer perspective, we designed Markov model-based cost-effectiveness analyses to compare the cost-effectiveness of three RRT modalities and four different scheduled policies to RRT modalities in Guangzhou over three time horizons (5, 10 and 15 years). The current situation (scenario 1: haemodialysis (HD), 73%; peritoneal dialysis (PD), 14%; kidney transplantation (TX), 13%) was compared with three different scenarios: an increased proportion of incident RRT patients on PD (scenario 2: HD, 47%; PD, 40%; TX, 13%); on TX (scenario 3: HD, 52%; PD, 14%; TX, 34%); on both PD and TX (Scenario 4: HD, 26%; PD, 40%; TX, 34%).ResultsOver 5-year time horizon, HD was dominated by PD. At a willingness-to-pay (WTP) threshold of US$44 300, TX was cost-effective compared with PD with an incremental cost-effectiveness ratio of US$35 518 per quality-adjusted life year (QALY) gained. The scenario 2 held a dominant position over the scenario 1, with a net saving of US$ 5.92 million and an additional gain of 6.24 QALYs. The scenarios 3 and 4 were cost-effective compared with scenario 1 at a WTP threshold of US$44 300. The above results were consistent across the three time horizons.ConclusionsTX is the most cost-effective RRT modality, followed in order by PD and HD. The strategy with an increased proportion of incident patients on PD and TX is cost-effective compared with the current practice pattern at the given WTP threshold. The planning for RRT service delivery should incorporate efforts to increase the utilisation of PD and TX in China.

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Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy

Cited by 19 publications

References 30 publications

Tackling Dialysis Burden around the World: A Global Challenge

Tackling Dialysis Burden around the World: A Global Challenge

Chronic kidney failure following lancehead bite envenoming: a clinical report from the Amazon region

Cost-effectiveness analysis of renal replacement therapy strategies in Guangzhou city, southern China

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