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Economic burden and cost-utility analysis of three renal replacement therapies in ESRD patients from Yunnan Province, China

  • Nephrology - Original Paper
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Abstract

Purpose

To compare the economic burden and cost-utility analysis of the renal replacement therapies, including hemodialysis (HD), peritoneal dialysis (PD), and allograft kidney transplantation (KT) among end-stage renal disease (ESRD) patients from Yunnan Province, China.

Methods

Multistage stratified random sampling method was used to select presentative sample of 298 patients from four hospitals in Yunnan Province. The two-step model was applied to calculate a direct economic burden; the human capital approach was used to analyze the indirect economic burden. SF-36 scale was applied to assess the quality of life, while the improving score of quality of life was used to evaluate the cost-utility score.

Results

A total of 298 patients were analyzed, including 108 HD patients, 91 PD patients and 99 KT patients. The mean unit economic expenses of HD, PD, and KT were $11,783.6 ± 402.63, $11,059.8 ± 709.51, and $21,151.1 ± 11,419.57, respectively. Based on the cost-utility analysis, the cost of improving one unit of quality of life in KT, PD, and HD was $599.86, $1373.89 and $2021.20, respectively; a significant difference was observed between the KT group and the HD or PD group (P < 0.05).

Conclusions

The economic burden of ESRD in Yunnan was substantial. The cost-utility was the best in the renal transplantation group. Kidney transplantation is still recommended as the first approach for patients with ESRD, followed by PD.

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Abbreviations

ESRD:

End-stage renal disease

HD:

Hemodialysis

PD:

Peritoneal dialysis

KD:

Kidney transplantation

QOL:

Quality of life

References

  1. Jha V, Garcia GG, Iseki K, Yang CW (2013) Chronic kidney disease: global dimension and perspectives. Lancet 382:260–272. https://doi.org/10.1016/S0140-6736(13)60687-X

    Article  PubMed  Google Scholar 

  2. Zhang L, Wang H (2009) Chronic kidney disease epidemic: cost and health care implications in China. Semin Nephrol 29:483–486. https://doi.org/10.1016/j.semnephrol.2009.06.012

    Article  PubMed  Google Scholar 

  3. Coresh J, Selvin E, Stevens LA, Levey AS (2007) Prevalence of chronic kidney disease in the United States. JAMA 298:2038–2047. https://doi.org/10.1001/jama.298.17.2038

    Article  PubMed  CAS  Google Scholar 

  4. Zhang L, Wang F, Wang L, Wang W, Liu B, Liu J (2012) Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet 379:815–822. https://doi.org/10.1016/S0140-6736(12)60033-6

    Article  PubMed  Google Scholar 

  5. Garcia GG, Jha V, World Kidney Day Steering Committee (2015) Chronic kidney disease in disadvantaged populations. Transplantation 99:13–16. https://doi.org/10.1097/TP.0000000000000558

    Article  Google Scholar 

  6. Feder J, Nadel MV, Krishnan M (2016) A matter of choice: opportunities and obstacles facing people with ESRD. Clin J Am Soc Nephrol 11:536–538. https://doi.org/10.2215/CJN.04470415

    Article  PubMed  Google Scholar 

  7. Gonzalez BM, Rosa DG, Pecoits FR, Douthat W, Ferreiro A, Garcia GG, Cusumano A (2015) Burden of disease: prevalence and incidence of ESRD in Latin America. Clin Nephrol 83:3–6. https://doi.org/10.5414/cnp83s003

    Article  Google Scholar 

  8. Xie F, Zhang D, Wu J, Zhang Y, Yang Q, Sun X (2012) Design and implementation of the first nationwide, web-based Chinese Renal Data System (CNRDS). BMC Med Inform Decis Mak 12:11. https://doi.org/10.1186/1472-6947-12-11

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jha V, Wang AY, Wang H (2012) The impact of CKD identification in large countries: the burden of illness. Nephrol Dial Transplant 3:32–38. https://doi.org/10.1093/ndt/gfs113

    Article  Google Scholar 

  10. Wang V, Vilme H, Maciejewski ML, Boulware LE (2016) The economic burden of chronic kidney disease and end-stage renal disease. Semin Nephrol 36:319–330. https://doi.org/10.1016/j.semnephrol.2016.05.008

    Article  PubMed  Google Scholar 

  11. Essue BM, Wong G, Chapman J, Li Q, Jan S (2013) How are patients managing with the costs of care for chronic kidney disease in Australia? A cross-sectional study. BMC Nephrol 14:5–8. https://doi.org/10.1186/1471-2369-14-5

    Article  PubMed  PubMed Central  Google Scholar 

  12. Yunnan Statistical Yearbook (2018) Compiled by Yunnan Province statistical Bureau. Beijing Statistics Press, China

    Google Scholar 

  13. Li Q, Cai L, Cui W, Wang G, He J, Golden AR (2018) Economic burden of obesity and four obesity-related chronic diseases in rural Yunnan Province. China Public Health 64:91–98. https://doi.org/10.1016/j.puhe.2018.07.024

    Article  Google Scholar 

  14. Feroze U, Martin D, Kalanter ZK, Kim J, Reina PA, Kopple JD (2012) Anxiety and depression in maintenance dialysis patients: preliminary data of a cross-sectional study and brief literature review. J RenNutr 22:207–210. https://doi.org/10.1053/j.jrn.2011.10.009

    Article  Google Scholar 

  15. Celik G, Annagu BB, Yılmaz M, Kara F (2012) Findings of multidimension an instruments for determining psychopathology in diabetic and non-diabetic hemodialysis patients. Int J ClinExp Med 5:346–354

    Google Scholar 

  16. Matter YE, Elhadedy MA, Abbas TM, Zahab MA, Fouda MA, Refaie AF, Sheashaa HA, Abbas MH (2018) Impact of sex disparities on outcomes of living-donor kidney transplant in Egypt: data of 979 patients. Exp Clin Transplant 16(2):133–137. https://doi.org/10.6002/ect.2016.0253

    Article  PubMed  Google Scholar 

  17. Peracha J, Hayer MK, Sharif A (2016) Gender disparity in living-donor kidney transplant among minority ethnic groups experimental and clinical transplantation. Exp Clin Transplant 14:139–145. https://doi.org/10.6002/ect.2015.0150

    Article  PubMed  Google Scholar 

  18. Piccoli GB, Alrukhaimi M, Liu ZH, Zakharova E, Levin A (2018) Women and kidney disease: reflections on world kidney day 2018: kidney health and Women's health: a case for optimizing outcomes for present and future generations. Nephrol Dial Transplant 33(2):189–193. https://doi.org/10.1093/ndt/gfx358

    Article  PubMed  Google Scholar 

  19. The national bureau of statistics of the People's Republic of China (2017) The People's Republic of China national economic and social development statistical bulletin in 2016 Publishing Physics Web. https://www.stats.gov.cn/tjsj/zxfb/201702/t20170228_1467424.html.

  20. Wang WY, Lian H, Lu W (2018) Analysis on treatment burden of end-stage renal disease patients and related policy suggestions. China Health Resour 21:121–126

    Google Scholar 

  21. Mapes DL, Lopes AA, Satayathum S, Mc CKP, Goodkin DA, Locatelli F (2003) Health-related quality of life as a predictor of mortality and hospitalization: the dialysis outcomes and practice patterns study (DOPPS). Kidney Int 64(1):339–349. https://doi.org/10.1046/j.1523-1755.2003.00072.x

    Article  PubMed  Google Scholar 

  22. Yetti K, Sukmarini L (2019) The factors affecting the quality of life of kidney transplantation patients at the CiptoMangunkusumo General Hospital in Jakarta, Indonesia. Enferm Clin 9:428–433. https://doi.org/10.1016/j.enfcli.2019.04.063

    Article  Google Scholar 

  23. Tamura Y, Urawa A, Watanabe S, Okad M (2018) Mood status and quality of life in kidney recipients after transplantation. Transplant Proc 50(8):2521–2525. https://doi.org/10.1016/j.transproceed.2018.03.077

    Article  PubMed  CAS  Google Scholar 

  24. Hoffman AL, Matemavi P (2018) Kidney transplantation and the impact on health-related quality of life in frail patients. Transplantation 102(2):183–184. https://doi.org/10.1097/TP.0000000000001979

    Article  PubMed  Google Scholar 

  25. Jiwakanon S, Chiu YW, Kalantar-Zadeh K, Mehrotra R (2010) Peritoneal dialysis: an underutilized modality. Curr Opin Nephrol Hypertens 19(6):573–577. https://doi.org/10.1097/MNH.0b013e32833d67a3

    Article  PubMed  Google Scholar 

  26. Finkelstein FO, Abu-Aisha H, Najafi I, Lo WK, Abraham G, Pecoits-Filho R, Süleymanlar G (2009) Peritoneal dialysis in the developing world: recommendations from a symposium at the ISPD meeting 2008. Perit Dial Int 29(6):618–622

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was supported by Grants from “the Union Specific Project Foundation of Yunnan Provincial Science and Technology Department and Kunming Medical University” [2017FE467(-037)], the “Teaching Educational Reform Project of Kunming Medical University” (2018-JY-Y-050), the “Project of Hundred of young and middle-aged academic and technical talent in Kunming Medical University” (60118260103) and “Project of medical talents training in Yunnan Health Committee” (2019) 14.

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Authors and Affiliations

  1. The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China

    Huixin Wu, Qing Li, Yaping Cai, Junlin Zhang & Zhu Zhou

  2. School of Public Health, Kunming Medical University, Kunming, 650500, Yunnan, China

    Huixin Wu & Wenlong Cui

Authors
  1. Huixin Wu
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  2. Qing Li
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  3. Yaping Cai
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  4. Junlin Zhang
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  6. Zhu Zhou
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Contributions

QL conceived the ideal, designed of the study and worked on the manuscript. HW conducted field study and drafted the original manuscript. YC conducted field study and investigation. JZ and WC collected the data. ZZ provided critical comments of the manuscript. All authors approved the final version of the manuscript.

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Correspondence to Qing Li.

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Wu, H., Li, Q., Cai, Y. et al. Economic burden and cost-utility analysis of three renal replacement therapies in ESRD patients from Yunnan Province, China. Int Urol Nephrol 52, 573–579 (2020). https://doi.org/10.1007/s11255-020-02394-1

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  • DOI: https://doi.org/10.1007/s11255-020-02394-1

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