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

<h4>Background</h4>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 multist...

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Autores principales:	Magdalena Walbaum, Shaun Scholes, Rubén Rojas, Jennifer S Mindell, Elena Pizzo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e36ce644e45341089314c01d0d4d1aef
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spelling	oai:doaj.org-article:e36ce644e45341089314c01d0d4d1aef2021-12-02T20:14:47ZProjection of the health and economic impacts of Chronic kidney disease in the Chilean population.1932-620310.1371/journal.pone.0256680https://doaj.org/article/e36ce644e45341089314c01d0d4d1aef2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256680https://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.Magdalena WalbaumShaun ScholesRubén RojasJennifer S MindellElena PizzoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0256680 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Magdalena Walbaum Shaun Scholes Rubén Rojas Jennifer S Mindell Elena Pizzo Projection of the health and economic impacts of Chronic kidney disease in the Chilean population.
description	<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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).<h4>Conclusions</h4>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.
format	article
author	Magdalena Walbaum Shaun Scholes Rubén Rojas Jennifer S Mindell Elena Pizzo
author_facet	Magdalena Walbaum Shaun Scholes Rubén Rojas Jennifer S Mindell Elena Pizzo
author_sort	Magdalena Walbaum
title	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_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_sort	projection of the health and economic impacts of chronic kidney disease in the chilean population.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e36ce644e45341089314c01d0d4d1aef
work_keys_str_mv	AT magdalenawalbaum projectionofthehealthandeconomicimpactsofchronickidneydiseaseinthechileanpopulation AT shaunscholes projectionofthehealthandeconomicimpactsofchronickidneydiseaseinthechileanpopulation AT rubenrojas projectionofthehealthandeconomicimpactsofchronickidneydiseaseinthechileanpopulation AT jennifersmindell projectionofthehealthandeconomicimpactsofchronickidneydiseaseinthechileanpopulation AT elenapizzo projectionofthehealthandeconomicimpactsofchronickidneydiseaseinthechileanpopulation
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Projection of the health and economic impacts of Chronic kidney disease in the Chilean population.

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