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Higher medical costs for CKD patients with a rapid decline in eGFR: A cohort study from the Japanese general population
To investigate how changes in eGFR can affect medical costs, a regional cohort of national health insurance beneficiaries in Japan was developed from a nationwide database system (Kokuho database, KDB), and non-individualized data were obtained. From 105,661 people, subjects on chronic dialysis and...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524806/ https://www.ncbi.nlm.nih.gov/pubmed/31100069 http://dx.doi.org/10.1371/journal.pone.0216432 |
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author | Nagai, Kei Iseki, Chiho Iseki, Kunitoshi Kondo, Masahide Asahi, Koichi Saito, Chie Tsunoda, Ryoya Okubo, Reiko Yamagata, Kunihiro |
author_facet | Nagai, Kei Iseki, Chiho Iseki, Kunitoshi Kondo, Masahide Asahi, Koichi Saito, Chie Tsunoda, Ryoya Okubo, Reiko Yamagata, Kunihiro |
author_sort | Nagai, Kei |
collection | PubMed |
description | To investigate how changes in eGFR can affect medical costs, a regional cohort of national health insurance beneficiaries in Japan was developed from a nationwide database system (Kokuho database, KDB), and non-individualized data were obtained. From 105,661 people, subjects on chronic dialysis and subjects without consecutive medical checkups were excluded. Finally, medical costs in the follow-up year categorized by annual changes in eGFR between baseline and the next year were longitudinally examined in 70,627 people ranging in age from 40 to 74 years. Global mean costs for subjects with a rapid decrease in eGFR (≤-30%/year) were the highest among all ΔeGFR categories. In men, the cost was 1.42 times that for a stable eGFR. A total of 6,268 (19.4%) men and 5,381 (14.0%) women with eGFR <60 ml/min/1.73 m(2) were identified in the baseline year. The mean cost was higher with a low eGFR than without a low eGFR, and there were also higher proportions newly initiating dialysis in 2014 (low eGFR with rapid decrease in eGFR vs. with stable eGFR: 9.61% vs. 0.02% in women, P<0.001). Moreover, the costs for low eGFR subjects with a rapid decrease in eGFR were more than twice those of non-low eGFR subjects with a rapid decrease in eGFR and also compared to low eGFR subjects with a stable eGFR. Moreover, initiating chronic dialysis was considered one of the major causes of high medical costs in women with rapid eGFR decline. To the best of our knowledge, this is the first study of renal disease using a cohort developed from the KDB system recently established in Japan. |
format | Online Article Text |
id | pubmed-6524806 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-65248062019-05-31 Higher medical costs for CKD patients with a rapid decline in eGFR: A cohort study from the Japanese general population Nagai, Kei Iseki, Chiho Iseki, Kunitoshi Kondo, Masahide Asahi, Koichi Saito, Chie Tsunoda, Ryoya Okubo, Reiko Yamagata, Kunihiro PLoS One Research Article To investigate how changes in eGFR can affect medical costs, a regional cohort of national health insurance beneficiaries in Japan was developed from a nationwide database system (Kokuho database, KDB), and non-individualized data were obtained. From 105,661 people, subjects on chronic dialysis and subjects without consecutive medical checkups were excluded. Finally, medical costs in the follow-up year categorized by annual changes in eGFR between baseline and the next year were longitudinally examined in 70,627 people ranging in age from 40 to 74 years. Global mean costs for subjects with a rapid decrease in eGFR (≤-30%/year) were the highest among all ΔeGFR categories. In men, the cost was 1.42 times that for a stable eGFR. A total of 6,268 (19.4%) men and 5,381 (14.0%) women with eGFR <60 ml/min/1.73 m(2) were identified in the baseline year. The mean cost was higher with a low eGFR than without a low eGFR, and there were also higher proportions newly initiating dialysis in 2014 (low eGFR with rapid decrease in eGFR vs. with stable eGFR: 9.61% vs. 0.02% in women, P<0.001). Moreover, the costs for low eGFR subjects with a rapid decrease in eGFR were more than twice those of non-low eGFR subjects with a rapid decrease in eGFR and also compared to low eGFR subjects with a stable eGFR. Moreover, initiating chronic dialysis was considered one of the major causes of high medical costs in women with rapid eGFR decline. To the best of our knowledge, this is the first study of renal disease using a cohort developed from the KDB system recently established in Japan. Public Library of Science 2019-05-17 /pmc/articles/PMC6524806/ /pubmed/31100069 http://dx.doi.org/10.1371/journal.pone.0216432 Text en © 2019 Nagai et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Nagai, Kei Iseki, Chiho Iseki, Kunitoshi Kondo, Masahide Asahi, Koichi Saito, Chie Tsunoda, Ryoya Okubo, Reiko Yamagata, Kunihiro Higher medical costs for CKD patients with a rapid decline in eGFR: A cohort study from the Japanese general population |
title | Higher medical costs for CKD patients with a rapid decline in eGFR: A cohort study from the Japanese general population |
title_full | Higher medical costs for CKD patients with a rapid decline in eGFR: A cohort study from the Japanese general population |
title_fullStr | Higher medical costs for CKD patients with a rapid decline in eGFR: A cohort study from the Japanese general population |
title_full_unstemmed | Higher medical costs for CKD patients with a rapid decline in eGFR: A cohort study from the Japanese general population |
title_short | Higher medical costs for CKD patients with a rapid decline in eGFR: A cohort study from the Japanese general population |
title_sort | higher medical costs for ckd patients with a rapid decline in egfr: a cohort study from the japanese general population |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524806/ https://www.ncbi.nlm.nih.gov/pubmed/31100069 http://dx.doi.org/10.1371/journal.pone.0216432 |
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