Cost‐effectiveness analysis of radiobasilic and brachiobasilic arteriovenous fistulas in hemodialysis patients

Abstract

We evaluated the cost and efficacy of radiobasilic and brachiobasilic arteriovenous fistula (AVF) methods in terms of forearm autogenous arteriovenous access in hemodialysis patients. We used a decision tree to compare the cost-effectiveness of proximal radiobasilic AVF (pRBAVF) and brachiobasilic AVF (BBAVF), considering the mean direct medical costs and patency rates. The overall mean cost of pRBAVF per patient (1767.59 Turkish lira [TL]) was lower than that of BBAVF (1877.99 TL). Also, the mean patency duration per patient was higher for pRBAVF (25.72 months) than BBAVF (20.21 months). The incremental cost-effectiveness ratio (ICER) showed that pRBAVF was 20.04-fold more effective than BBAVF. The monthly ICERs also favored pRBAVF, which was less costly and more effective. The pRBAVF provided clinical and economic benefits for hemodialysis patients requiring forearm autogenous arteriovenous access. pRBAVF was more effective in terms of patency than BBAVF, and was also less expensive.

Stages of Change-Based Nursing Interventions for Compliance, Anemia, Cardiac Function and Inflammatory Factors in CKD Patients Undergoing Hemodialysis

“…This stage of the disease calls for renal transplantation therapy, or if not feasible, renal replacement therapy, to sustain the patient's life [1][2]. Hemodialysis, as one of the main modalities of clinical treatment for patients with chronic kidney disease (CKD), is capable of clearing metabolic wastes, toxins, and excess water from the bodies of CKD patients to maintain their vital functions [3]. However, patients undergoing hemodialysis are susceptible to a variety of complications, such as osteoporosis, malnutrition, etc., resulting in impaired ability to perform daily life; and those who receive maintenance hemodialysis are also vulnerable to debilitating symptoms, leading to negative emotions [4].…”