Prospective analysis of global costs for maintenance of patients with ESRD

Ploth, David W.; Shepp, Pamela H.; Counts, Caroline A.; Hutchison, Florence N.

doi:10.1016/s0272-6386(03)00404-9

Cited by 39 publications

(20 citation statements)

References 11 publications

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“…As a consequence, cardiovascular causes appear to be responsible for a disproportionate expenditure in healthcare for this subgroup of patients. 9 A powerful association between diabetes mellitus and PAD was demonstrated in this hemodialysis population, with age and vintage showing a significant interactive effect in modulating the effect of diabetes. Whereas vintage appeared to be able to modulate the risk of having PAD in nondiabetic as well as diabetic patients, age modulated the risk for PAD only in patients without diabetes mellitus.…”

Section: Discussionmentioning

confidence: 79%

Peripheral Arterial Disease in Patients With End-Stage Renal Disease

et al. 2006

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Section: Discussionmentioning

confidence: 79%

Peripheral Arterial Disease in Patients With End-Stage Renal Disease

et al. 2006

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“…Estimates using the US Renal Data System (USRDS) suggest that in 2010 approximately 20 million Americans aged $20 years had CKD; 0.39 million had ESRD, excluding persons with renal transplants (3)(4)(5)(6). Persons with these conditions are frequently hospitalized and incur greater costs and complications associated with their hospitalizations (7).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Embolism in Patients with CKD and ESRD

Kumar

Sakhuja

Taneja

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives CKD and ESRD are growing burdens. It is unclear whether these conditions affect pulmonary embolism (PE) risk, given that they affect both procoagulant and anticoagulant factors. This study examined the frequency and associated outcomes of PE in CKD and ESRD.Design, setting, participants, & measurements The Healthcare Cost and Utilization Project's Nationwide Inpatient Sample was used to estimate the frequency and outcomes of PE in adults with CKD and ESRD. Hospitalizations for the principal diagnosis of PE and presence of CKD or ESRD were identified using International Classification of Diseases, Ninth Revision codes. Data from the annual US Census and US Renal Data System reports were used to calculate the number of adults with CKD, ESRD, and normal kidney function (NKF) as well as the annual incidence of PE in each group. Logistic regression modeling was used to compare in-hospital mortality among persons admitted for PE who had ESRD or CKD to those without these conditions. ResultsThe annual frequency of PE was 527 per 100,000, 204 per 100,000, and 66 per 100,000 persons with ESRD, CKD, and NKF, respectively. In-hospital mortality was higher for persons with ESRD and CKD (P,0.001) compared with persons with NKF. Median length of stay was longer by 1 day in CKD and 2 days in ESRD than among those with NKF.Conclusions Persons with CKD and ESRD are more likely to have PE than persons with NKF. Once they have PE, they are more likely to die in the hospital.

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“…Nevertheless, the European Best Practice Guidelines 2002 advocate the use of LMWH in lieu of UFH as anticoagulation on HD because of ‘proven safety’, equal efficacy and easy handling, an improved lipid and bone profile, less hyperkalaemia and reduced blood loss (EBPG). This position, however, may not be economically viable given previous publications, which suggest that anticoagulation with LMWH is a more expensive option than UFH [9, 10], particularly when one considers the escalating cost of dialysis worldwide [11, 12]. …”

Section: Introductionmentioning

confidence: 99%

Comparison of Tinzaparin™ and Unfractionated Heparin as Anticoagulation on Haemodialysis: Equal Safety, Efficacy and Economical Parity

et al. 2008

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Background: The European Best Practice Guidelines on anticoagulation in chronic haemodialysis recommend the use of low-molecular-weight heparins (LMWH) over unfractionated heparin (UFH), based on previous small-scale studies and a meta-analysis which demonstrated equal efficacy of anticoagulation without an increase in hemorrhagic events. Method: We performed a prospective single-centre study where all stable patients on chronic in-hospital haemodialysis were converted from UFH to Tinzaparin™. Patients were monitored for 2 months before and 2 months after the switch. Access failures due to thrombosis, clotted circuits and hemorrhagic events were recorded. Results: 1,489 and 1,823 dialysis sessions took place on UFH and LMWH, respectively, in 108 patients (65 male). The total number of clotted circuits tended to decrease after the switch to LMWH (34 vs. 13) but was not statistically significant. There were four minor non-access-related episodes of haemorrhage while on treatment with UFH and none with Tinzaparin, and the length of bleeding time post needle removal was shorter with Tinzaparin than UFH. The cost-analysis demonstrated parity of Tinzaparin with UFH; using a median of 10,000 U of UFH versus 2,500 U of LMWH, each therapy cost GBP 10,783 (EUR 15,942; USD 20,446) per annum. Conclusion: Our findings suggest comparable safety and efficacy of Tinzaparin, parity of cost in comparison with UFH.

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Prospective analysis of global costs for maintenance of patients with ESRD

Cited by 39 publications

References 11 publications

Peripheral Arterial Disease in Patients With End-Stage Renal Disease

Peripheral Arterial Disease in Patients With End-Stage Renal Disease

Pulmonary Embolism in Patients with CKD and ESRD

Comparison of Tinzaparin™ and Unfractionated Heparin as Anticoagulation on Haemodialysis: Equal Safety, Efficacy and Economical Parity

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