Life-Time Risk, Screening and The Cost of Cardiovascular Comorbidities in CKD Patients

Open access

Abstract

CKD is a problem of epidemic dimension. The risk of death and cardiovascular complications in this condition is of the same order of that by myocardial infarction, which qualifies CKD as “risk equivalent”. Calculations made on the basis of the epidemiological data of the MONICA-Augsburg study and analyses of the costs of myocardial infarction in a large health insurance company in Germany show that the economic burden of cardiovascular comorbidities with CKD in this country is substantial. These estimates, which may be valid also for other large member states of the European Community, represent a call for studies looking at the cost-effectiveness of preventive interventions aimed at reducing the risk for CKD and at lowering the concerning incidence rate of death and disability due to CKD-triggered cardiovascular complications in CKD patients.

1. Levey AS, Stevens LA, Coresh J. Conceptual model of CKD: applications and implications. Am J Kidney Dis. 2009; 53: S4-16.

2. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39: S1-266.

3. Zhang QL, Rothenbacher D. Prevalence of chronic kidney disease in population-based studies: systematic review. BMC Public Health. 2008; 8: 117.

4. Tonelli M, Riella M. Chronic kidney disease and the ageing population. Lancet. 2014; 383: 1278-1279.

5. Gansevoort RT, Correa-Rotter R, Hemmelgarn BR et al. Chronic kidney disease and cardiovascular risk: epidemiology, mechanisms, and prevention. Lancet. 2013; 382: 339-352.

6. Grams ME, Juraschek SP, Selvin E et al. Trends in the prevalence of reduced GFR in the United States: a comparison of creatinine- and cystatin C-based estimates. Am J Kidney Dis. 2013; 62: 253-260.

7. Zoccali C. Cardiorenal risk as a new frontier of nephrology: research needs and areas for intervention. Nephrol Dial Transplant. 2002; 17 Suppl 11: 50-54.

8. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106: 3143-3421.

9. Tonelli M, Muntner P, Lloyd A et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet. 2012; 380: 807-814.

10. Stone NJ, Robinson JG, Lichtenstein AH et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 129: S1-45.

11. Grams ME, Chow EK, Segev DL, Coresh J. Lifetime incidence of CKD stages 3-5 in the United States. Am J Kidney Dis. 2013; 62: 245-252.

12. Hoerger TJ, Wittenborn JS, Segel JE et al. A health policy model of CKD: 2. The cost-effectiveness of microalbuminuria screening. Am J Kidney Dis. 2010; 55: 463-473.

13. Fink HA, Ishani A, Taylor BC et al. Screening for, monitoring, and treatment of chronic kidney disease stages 1 to 3: a systematic review for the U.S. Preventive Services Task Force and for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2012; 156: 570-581.

14. Qaseem A, Hopkins RH, Jr., Sweet DE et al. Screening, monitoring, and treatment of stage 1 to 3 chronic kidney disease: A clinical practice guideline from the American College of Physicians. Ann Intern Med. 2013; 159: 835-847.

15. Hill NR, Lasserson D, Fatoba S et al. The Oxford Renal (OxRen) cross-sectional study of chronic kidney disease in the UK. BMJ Open. 2013; 3: e004265.

16. Meisinger C, Doring A, Lowel H. Chronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population. Eur Heart J. 2006; 27: 1245-1250.

17. Reinhold T, Lindig C, Willich SN, Bruggenjurgen B. The costs of myocardial infarction - a longitudinal analysis using data from a large German health insurance company. J Public Health 19, 579-586. 2011.

18. Icks A, Haastert B, Gandjour A et al. Costs of dialysis-- a regional population-based analysis. Nephrol Dial Transplant. 2010; 25: 1647-1652.

19.http://epp.eurostat.ec.europa.eu/statistics_explained/index.php/File:Gross_domestic_product_at_market_prices_2011.png. Eurostat. 2014.

PRILOZI

Section of Medical Sciences

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CiteScore 2017: 0.45

SCImago Journal Rank (SJR) 2018: 0.177

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