Prk4: Cost Analysis of Non-Dialysis Renal Insufficiency (Ndri): An Employer's Perspective

Boyce, SP; Buteau, Sharon; Crémieux, PY; Mody, SH; Piech, Catherine Tak

doi:10.1016/s1098-3015(10)64067-3

Value in Health

2003

DOI: 10.1016/s1098-3015(10)64067-3

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Prk4: Cost Analysis of Non-Dialysis Renal Insufficiency (Ndri): An Employer's Perspective

SP Boyce¹,

Sharon Buteau²,

PY Crémieux³

et al.

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2011

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“…Shlipak et al (3) found that frailty but not disability was associated with chronic renal insufficiency in elderly persons. However, it has been estimated that disability and absenteeism account for about 25% of the total health-related costs of CKD (14,15). …”

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confidence: 99%

Association of CKD With Disability in the United States

Plantinga

Johansen

Crews³

et al. 2011

American Journal of Kidney Diseases

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Background Little is known about disability in early-stage chronic kidney disease (CKD). Study Design Cross-sectional national survey (National Health and Nutrition Examination Survey 1999–2006). Setting and Participants Community-based survey of 16,011 non-institutionalized U.S. civilian adults (≥20 years). Predictor CKD, categorized as: no CKD, stages 1 and 2 [albuminuria and estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2], and stages 3 and 4 (eGFR 15–59). Outcome Self-reported disability, defined by limitations in working, walking, and cognition; and difficulties in activities of daily living (ADL), instrumental ADL, leisure and social activities, lower extremity mobility, and general physical activity. Measurements Albuminuria and eGFR assessed from urine and blood samples; disability, demographics, access to care, and comorbid conditions assessed by standardized questionnaire. Results Age-adjusted prevalence of reported limitations was generally significantly greater with CKD: e.g., difficulty with ADLs was reported by 17.6%, 24.7%, and 23.9% of older (≥65 years) and 6.8%, 11.9%, and 11.0% of younger (20–64 years) adults with no CKD, stages 1 and 2, and stages 3 and 4, respectively. CKD was also associated with greater reported limitations and difficulty in other activities after age adjustment, including instrumental ADL, leisure and social activities, lower extremity mobility, and general physical activity. Other demographics, socioeconomic status, and access to care generally only slightly attenuated the observed associations, particularly among older individuals; adjustment for cardiovascular disease, arthritis, and cancer attenuated most associations such that statistical significance was no longer achieved. Limitations Inability to establish causality and possible unmeasured confounding. Conclusion CKD is associated with higher prevalence of disability in the United States. Age and other comorbid conditions account for most, but not all, of this association.

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mentioning

confidence: 99%

Association of CKD With Disability in the United States

Plantinga

Johansen

Crews³

et al. 2011

American Journal of Kidney Diseases

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Prk4: Cost Analysis of Non-Dialysis Renal Insufficiency (Ndri): An Employer's Perspective

Cited by 1 publication

References 0 publications

Association of CKD With Disability in the United States

Association of CKD With Disability in the United States

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