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Healthcare costs of the progression of chronic kidney disease and different dialysis techniques estimated through administrative database analysis

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Abstract

Background

Chronic kidney disease (CKD) progression is associated with significant comorbidities and costs. In Italy, limited evidence of healthcare resource consumption and costs is available. We therefore aimed to investigate the direct healthcare costs in charge to the Lombardy Regional Health Service (RHS) for the treatment of CKD patients in the first year after starting hemodialysis and in the 2 years prior to dialysis.

Methods

Citizens resident in the Lombardy Region (Italy) who initiated dialysis in the year 2011 (Jan 1 to Dec 31) were selected and data were extracted from Lombardy Regional databases on their direct healthcare costs in the first year after starting dialysis and in the 2 years prior to it was analyzed. Drugs, hospitalizations, diagnostic procedures and outpatient costs covered by RHS were estimated. Patients treated for acute kidney injury, or who died or stopped dialysis during the observational period were excluded.

Results

From the regional population (>9,700,000 inhabitants), 1067 patients (34.3 % females) initiating dialysis were identified, of whom 82 % underwent only hemodialysis (HD), 13 % only peritoneal dialysis (PD) and the remaining 5 % both treatments. Direct healthcare costs/patient were € 5239, € 12,303 and € 38,821 (€ 40,132 for HD vs. € 30,444 for PD patients) for the periods 24–12 months pre-dialysis, 12–0 months pre-dialysis, and in the first year of dialysis, respectively.

Conclusions

This study highlights a significant economic burden related to CKD and an increase in direct healthcare costs associated with the start of dialysis, pointing to the importance of prevention programs and early diagnosis.

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Acknowledgments

ReNe, Renal Lombardy Network (Centre, Director) Bergamo, Prof. G. Remuzzi; Bergamo Gavazzeni, Dr. G. Mingardi; Zingonia, Dr. M. Lorenz; Ponte San Pietro, Dr. A. Meterangelis; Treviglio, Dr. E.G. Galli; Seriate, Dr. L. Pedrini; Brescia Spedali Civili, Prof. G. Cancarini; Montichiari, Prof. F. Scolari; Desenzano, Dr. M. Brognoli; Gavardo, Dr. M. Brognoli; Manerbio, Dr. M. Brognoli; Chiari, Dr. M. Bracchi; Esine, Dr. M. G. Cattaneo; Como S. Anna, Dr. C. Minoretti; Lecco, Dr. G. Pontoriero; Crema, Dr. G. De Petri; Cremona, Dr. F. Malberti; Mantova, Dr. P.L. Botti; Bollate, Dr. U. Teatini; Cernusco S.N, Dr. O. Bracchi; Cinisello B, Dr. C. Pozzi; Desio, Dr. R. Scanziani; Legnano, Dr. C. Guastoni; Lodi, Dr. M. Farina; Magenta, Dr. C. Guastoni; Melegnano, Dr. S. Bisegna; Milano De Marchi, Dr. G.Montini; Niguarda, Dr. G. Colussi, Policilinico IRCCS Croff, Prof. P.G. Messa; S. Carlo, Dr. M. Gallieni; Milano S. Paolo, Prof. M. Cozzolino; Milano Simone Martini, Dr. D. Brancaccio; Monza, Prof. A. Stella; Vimercate, Dr. G.M. Ferrario; Casa di Cura S. Donato, Dr. M. Doria; Milano Sacco, Dr. A. Genderini; Milano H.S.R, Dr. D. Spotti; Milano FBF, Dr. A. Limido; Multimedica, Dr. S. Bertoli; Paderno Dugnano, Dr. C. Rovati; Policlinico Monza, Dr. C. Ballabeni; Milano San Faustino, Dr. R. Galato; Humanitas, Dr. S. Badalamenti; Pavia Fond. Maugeri, Prof. A. Dal Canton; Pavia S. Matteo, Dr. C. Esposito; Vigevano, Dr. R. Bellazzi; Voghera, Dr. F. Milanesi; Sondrio, Dr. C. Colturi; Busto Arsizio, Dr. A. Castiglioni; Gallarate, Dr. E. Caretta; Varese Macchi, Dr. G. Rombolà; Tradate, Dr. P. Scalia; Castellanza, Dr. S. Bertoli.

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Authors and Affiliations

  1. Health Economics, ProCure Solutions, Via Camozzi 1/c, 24027, Nembro, Bergamo, Italy

    Alessandro Roggeri & Daniela Paola Roggeri

  2. Regional Health Authority, Lombardy Region, Milan, Italy

    Carlo Zocchetti & Maurizio Bersani

  3. Nephrology Unit, S. Uboldo Hospital, Cernusco sul Naviglio, Italy

    Ferruccio Conte

Authors
  1. Alessandro Roggeri
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  2. Daniela Paola Roggeri
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  3. Carlo Zocchetti
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  4. Maurizio Bersani
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  5. Ferruccio Conte
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Consortia

ReNe (Renal Lombardy Network)

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Corresponding author

Correspondence to Alessandro Roggeri.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

As the study is retrospective, observational and data were extracted from the administrative database of Lombardy Region in an anonymous way, the ethical committees evaluation is not necessary.

Research involving human participants and/or animals

Not applicable because the study was observational and retrospective.

Informed consent

All data of the present study regarding patients were extracted already anonymized from the administrative databases of the Lombardy Region and analyzed in an anonymous way; therefore informed consent is not applicable.

Additional information

The list of authors of ReNe (Renal Lombardy Network) are listed in acknowledgments.

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Roggeri, A., Roggeri, D.P., Zocchetti, C. et al. Healthcare costs of the progression of chronic kidney disease and different dialysis techniques estimated through administrative database analysis. J Nephrol 30, 263–269 (2017). https://doi.org/10.1007/s40620-016-0291-8

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  • DOI: https://doi.org/10.1007/s40620-016-0291-8

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