The health-economic impact of urine albumin-to-creatinine ratio testing for chronic kidney disease in Japanese non-diabetic patients.

IF 2.2 4区医学 Q2 UROLOGY & NEPHROLOGY Clinical and Experimental Nephrology Pub Date : 2024-12-16 DOI:10.1007/s10157-024-02600-9

Tsuneo Konta, Koichi Asahi, Kouichi Tamura, Fumitaka Tanaka, Akira Fukui, Yusuke Nakamura, Junichi Hirose, Kenichi Ohara, Yoko Shijoh, Matthew Carter, Kimberley Meredith, James Harris, Örjan Åkerborg, Naoki Kashihara, Takashi Yokoo

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Abstract

Background: The objective of this analysis was to estimate the clinical and economic impact of undertaking urine albumin-to-creatinine ratio (UACR) testing alongside regular estimated glomerular filtration rate testing for chronic kidney disease in non-diabetic Japanese patients versus no testing and versus urine protein-creatinine ratio (UPCR) testing.

Methods: An economic model, taking a Japanese healthcare perspective, estimated the health-economic impact of UACR testing over a lifetime time horizon. Outcomes reported were additional costs, clinical benefits measured, such as prevented dialyses and cardiovascular events, quality-adjusted life years gained, and incremental cost-effectiveness ratios. Health states were derived from risk levels reported in the Kidney Disease: Improving Global Outcomes heatmap. Results were derived assuming that after testing, treatment was available in the form of current standard-of-care or emerging chronic kidney disease therapies.

Results: Repeated UACR testing was found to be cost-effective compared to both no urine testing and UPCR testing, with incremental cost-effectiveness ratios of ¥1,953,958 and ¥1,966,433, respectively.

Conclusion: Overall, this model demonstrates the health-economic value of undertaking UACR testing within the non-diabetic Japanese population.

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日本非糖尿病患者慢性肾病尿白蛋白与肌酐比值检测对健康经济的影响。

背景：这项分析的目的是估算在对非糖尿病日本患者进行慢性肾病估算肾小球滤过率检测的同时进行尿白蛋白肌酐比值（UACR）检测与不进行检测和进行尿蛋白肌酐比值（UPCR）检测的临床和经济影响：方法：一个经济模型从日本医疗保健的角度出发，估算了尿蛋白肌酐比值检测在一生中对健康经济的影响。报告的结果包括额外成本、临床效益（如避免透析和心血管事件）、质量调整生命年收益以及增量成本效益比。健康状况来自肾脏病报告的风险水平：改善全球结果热图》中报告的风险水平得出。结果的得出是假定在检测后，可以采用目前的标准疗法或新兴的慢性肾脏病疗法进行治疗：结果：与不进行尿液检测和 UPCR 检测相比，重复 UACR 检测具有成本效益，其增量成本效益比分别为 ¥1,953,958 和 ¥1,966,433：总之，该模型证明了在非糖尿病日本人群中进行 UACR 检测的健康经济价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-

CiteScore

4.10

自引率

4.30%

发文量

135

审稿时长

4-8 weeks

期刊介绍： Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.