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Projection of the health and economic impacts of Chronic kidney disease in the Chilean population

BACKGROUND: Chronic Kidney Disease (CKD) is a leading public health problem, with substantial burden and economic implications for healthcare systems, mainly due to renal replacement treatment (RRT) for end-stage kidney disease (ESKD). The aim of this study is to develop a multistate predictive mode...

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Autores principales: Walbaum, Magdalena, Scholes, Shaun, Rojas, Rubén, Mindell, Jennifer S., Pizzo, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425564/
https://www.ncbi.nlm.nih.gov/pubmed/34495980
http://dx.doi.org/10.1371/journal.pone.0256680
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author Walbaum, Magdalena
Scholes, Shaun
Rojas, Rubén
Mindell, Jennifer S.
Pizzo, Elena
author_facet Walbaum, Magdalena
Scholes, Shaun
Rojas, Rubén
Mindell, Jennifer S.
Pizzo, Elena
author_sort Walbaum, Magdalena
collection PubMed
description BACKGROUND: Chronic Kidney Disease (CKD) is a leading public health problem, with substantial burden and economic implications for healthcare systems, mainly due to renal replacement treatment (RRT) for end-stage kidney disease (ESKD). The aim of this study is to develop a multistate predictive model to estimate the future burden of CKD in Chile, given the high and rising RRT rates, population ageing, and prevalence of comorbidities contributing to CKD. METHODS: A dynamic stock and flow model was developed to simulate CKD progression in the Chilean population aged 40 years and older, up to the year 2041, adopting the perspective of the Chilean public healthcare system. The model included six states replicating progression of CKD, which was assumed in 1-year cycles and was categorised as slow, medium or fast progression, based on the underlying conditions. We simulated two different treatment scenarios. Only direct costs of treatment were included, and a 3% per year discount rate was applied after the first year. We calibrated the model based on international evidence; the exploration of uncertainty (95% credibility intervals) was undertaken with probabilistic sensitivity analysis. RESULTS: By the year 2041, there is an expected increase in cases of CKD stages 3a to ESKD, ceteris paribus, from 442,265 (95% UI 441,808–442,722) in 2021 to 735,513 (734,455–736,570) individuals. Direct costs of CKD stages 3a to ESKD would rise from 322.4M GBP (321.7–323.1) in 2021 to 1,038.6M GBP (1,035.5–1,041.8) in 2041. A reduction in the progression rates of the disease by the inclusion of SGLT2 inhibitors and pre-dialysis treatment would decrease the number of individuals worsening to stages 5 and ESKD, thus reducing the total costs of CKD by 214.6M GBP in 2041 to 824.0M GBP (822.7–825.3). CONCLUSIONS: This model can be a useful tool for healthcare planning, with development of preventive or treatment plans to reduce and delay the progression of the disease and thus the anticipated increase in the healthcare costs of CKD.
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spelling pubmed-84255642021-09-09 Projection of the health and economic impacts of Chronic kidney disease in the Chilean population Walbaum, Magdalena Scholes, Shaun Rojas, Rubén Mindell, Jennifer S. Pizzo, Elena PLoS One Research Article BACKGROUND: Chronic Kidney Disease (CKD) is a leading public health problem, with substantial burden and economic implications for healthcare systems, mainly due to renal replacement treatment (RRT) for end-stage kidney disease (ESKD). The aim of this study is to develop a multistate predictive model to estimate the future burden of CKD in Chile, given the high and rising RRT rates, population ageing, and prevalence of comorbidities contributing to CKD. METHODS: A dynamic stock and flow model was developed to simulate CKD progression in the Chilean population aged 40 years and older, up to the year 2041, adopting the perspective of the Chilean public healthcare system. The model included six states replicating progression of CKD, which was assumed in 1-year cycles and was categorised as slow, medium or fast progression, based on the underlying conditions. We simulated two different treatment scenarios. Only direct costs of treatment were included, and a 3% per year discount rate was applied after the first year. We calibrated the model based on international evidence; the exploration of uncertainty (95% credibility intervals) was undertaken with probabilistic sensitivity analysis. RESULTS: By the year 2041, there is an expected increase in cases of CKD stages 3a to ESKD, ceteris paribus, from 442,265 (95% UI 441,808–442,722) in 2021 to 735,513 (734,455–736,570) individuals. Direct costs of CKD stages 3a to ESKD would rise from 322.4M GBP (321.7–323.1) in 2021 to 1,038.6M GBP (1,035.5–1,041.8) in 2041. A reduction in the progression rates of the disease by the inclusion of SGLT2 inhibitors and pre-dialysis treatment would decrease the number of individuals worsening to stages 5 and ESKD, thus reducing the total costs of CKD by 214.6M GBP in 2041 to 824.0M GBP (822.7–825.3). CONCLUSIONS: This model can be a useful tool for healthcare planning, with development of preventive or treatment plans to reduce and delay the progression of the disease and thus the anticipated increase in the healthcare costs of CKD. Public Library of Science 2021-09-08 /pmc/articles/PMC8425564/ /pubmed/34495980 http://dx.doi.org/10.1371/journal.pone.0256680 Text en © 2021 Walbaum et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://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
Walbaum, Magdalena
Scholes, Shaun
Rojas, Rubén
Mindell, Jennifer S.
Pizzo, Elena
Projection of the health and economic impacts of Chronic kidney disease in the Chilean population
title Projection of the health and economic impacts of Chronic kidney disease in the Chilean population
title_full Projection of the health and economic impacts of Chronic kidney disease in the Chilean population
title_fullStr Projection of the health and economic impacts of Chronic kidney disease in the Chilean population
title_full_unstemmed Projection of the health and economic impacts of Chronic kidney disease in the Chilean population
title_short Projection of the health and economic impacts of Chronic kidney disease in the Chilean population
title_sort projection of the health and economic impacts of chronic kidney disease in the chilean population
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425564/
https://www.ncbi.nlm.nih.gov/pubmed/34495980
http://dx.doi.org/10.1371/journal.pone.0256680
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