Abstract:
BACKGROUND:The recent multicenter, randomized, open-label INDEPENDENT study demonstrated that sevelamer improves survival in new to hemodialysis (HD) patients compared with calcium carbonate. The objective of this study was to determine the cost-effectiveness of sevelamer versus calcium carbonate for patients new to HD, using patient-level data from the INDEPENDENT study. STUDY DESIGN:Cost-effectiveness analysis. SETTING AND POPULATION:Adult patients new to HD in Italy. MODEL, PERSPECTIVE, TIMEFRAME:A patient-level cost-effectiveness analysis was conducted from the perspective of the Servizio Sanitario Nazionale, Italy's national health service. The analysis was conducted for a 3-year time horizon. The cost of dialysis was excluded from the base case analysis. INTERVENTION:Sevelamer was compared to calcium carbonate. OUTCOMES:Total life years (LYs), total costs, and the incremental cost per LY gained were calculated. Bootstrapping was used to estimate confidence intervals around LYs, costs, and cost-effectiveness and to calculate the cost-effectiveness acceptability curve. RESULTS:Sevelamer was associated with a gain of 0.26 in LYs compared to calcium carbonate, over the 3-year time horizon. Total drug costs were €3,282 higher for sevelamer versus calcium carbonate, while total hospitalization costs were €2,020 lower for sevelamer versus calcium carbonate. The total incremental cost of sevelamer versus calcium carbonate was €1,262, resulting in a cost per LY gained of €4,897. The bootstrap analysis demonstrated that sevelamer was cost effective compared with calcium carbonate in 99.4 % of 10,000 bootstrap replicates, assuming a willingness-to-pay threshold of €20,000 per LY gained. LIMITATIONS:Data on hospitalizations was taken from a post hoc retrospective chart review of the patients included in the INDEPENDENT study. Patient quality of life or health utility was not included in the analysis. CONCLUSIONS:Sevelamer is a cost-effective alternative to calcium carbonate for the first-line treatment of hyperphosphatemia in new to HD patients in Italy.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Ruggeri M,Bellasi A,Cipriani F,Molony D,Bell C,Russo D,Di Iorio Bdoi
10.1007/s40620-014-0122-8subject
Has Abstractpub_date
2015-10-01 00:00:00pages
593-602issue
5eissn
1121-8428issn
1724-6059pii
10.1007/s40620-014-0122-8journal_volume
28pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Congenital nephrotic syndrome is an uncommon disorder that may be caused by several diseases. These may be inherited, sporadic, acquired or part of a general malformation syndrome. METHODS:We reviewed the clinical characteristics, pathologic findings, and results of medical management in 30 infants who pres...
journal_title:Journal of nephrology
pub_type: 杂志文章
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更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Malnutrition is common and associated with poor outcomes in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD). Recently, the geriatric nutritional risk index (GNRI) was reported as a novel tool for evaluating nutritional status. However, the association between GNRI and renal outc...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-019-00676-1
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abstract::Thales was born into a noble family of Phoenician origin at the time of the 25th Olympiad (floruit 585 bc; he was 40 in the year of the solar eclipse. He had no teachers but had occasion to learn from Egyptian priests. He developed into a scholar and politician very much appreciated by Heraclitus, Herodotus and Democr...
journal_title:Journal of nephrology
pub_type: 传,历史文章,杂志文章
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abstract::There is little doubt that molecular biological intervention therapy has come of age and its potential is arousing tremendous excitement. A gene transfer technique, the HVJ-liposome method, is now applicable as a tool for the dissection of molecular aspects in the pathophysiology of renal diseases, and for gene therap...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Recently, some studies have emphasized the role of plasma 25-(OH)vitamin D (25OHD) levels in mineral metabolism dysregulation in chronic kidney diseases (CKDs). However, to date little attention has been paid to 25OHD metabolism abnormalities after renal transplantation (Tx). This cross-sectional study aimed...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::The hallmark of IgA nephropathy (IgAN) is macroscopic hematuria coinciding with, or immediately following, a mucosal infection, usually of the upper respiratory airways. The role of mucosal pathogens has been proven in different experimental models. Mucosal (or innate) immunity acts through the recognition of pathogen...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Serum adiponectin is inversely linked to obesity, impaired glucose homeostasis, dyslipidemia and hypertension and has been suggested as a possible marker of cardiovascular (CV) disease in the general population. However, its role in chronic kidney disease and following renal transplantation is not well estab...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND AND AIMS:Arterial stiffness is a risk factor for chronic kidney disease progression (CKD). Pulse pressure is a surrogate marker of arterial stiffness. It is unclear if pulse pressure predicts CKD progression in type 2 diabetes mellitus. METHODS:This was prospective study involving 1494 patients with estimat...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-020-00954-3
更新日期:2021-01-25 00:00:00
abstract::Diabetic kidney disease (DKD) affects approximately one-third of patients with diabetes and taking into consideration the high cardiovascular risk burden associated to this condition a multifactorial therapeutic approach is traditionally recommended, in which glucose and blood pressure control play a central role. The...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:10.1007/s40620-020-00803-3
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abstract::Organ transplantation has proven to be an effective therapeutic for a wide variety of disease states, but the chronic immunosuppression required for allograft survival increases the risk for infection and neoplasia. In the past 50 years, a wealth of experimental data has been accumulated relating to strategies to pres...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
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更新日期:2010-05-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
abstract::IgA nephropathy (IgAN) is characterised by the mesangial deposition of polymeric IgA1 (pIgA1). pIgA1 production is reduced in the mucosal immune system in IgAN and increased in the marrow; this switch may be secondary to a defect in gammadeltaT cell control of IgA production. However this does not explain the mechanis...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1999-03-01 00:00:00
abstract::The kidney does not usually present specific lesions in cystic fibrosis (CF), although in recent years renal involvement has been reported, particularly amyloidosis and immune complex glomerulonephritis. IgA nephropathy is rare. We report four cases of IgA nephropathy out of five renal biopsies performed in the last t...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Clinical immunology laboratories play an essential role in diagnosis and monitoring of systemic lupus erythematosus (SLE). To obtain the best results in terms of diagnostic performance and clinical usefulness, the following recommendations should be fulfilled: Indirect immunofluorescence on Hep-2 cells remains the met...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2002-11-01 00:00:00
abstract::The role of the kidney in controlling and maintaining plasma potassium levels in the normal range requires the presence and activity of renal potassium channels, and their importance has been highlighted in patients with Bartter syndrome harboring mutations in the ROMK (Kir1.1, KCJN1) channel and hyperkalemia. However...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Accurate assessment of kidney function level is the key to the identification and management of chronic kidney disease (CKD). Glomerular filtration rate (GFR) is the best measure of overall kidney function in health and disease. There is no consensus about the method to be used routinely to measure and/or es...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2006-03-01 00:00:00
abstract::Chronic renal failure (CRF) is associated with a 20-fold increased risk of cardiovascular death, two principal mechanisms being: sudden, arrhythmic death associated with left ventricular hypertrophy, and ischaemic heart disease, associated with accelerated atherosclerosis. In recent years, the vascular endothelium has...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2000-03-01 00:00:00
abstract::On September 11, 1945, Maria Schafstaat was the first patient who successfully underwent a dialysis treatment for acute kidney injury (AKI). The ingenious design of the first dialysis machine, made of cellophane tubing wrapped around a cylinder that rotated in a bath of fluid, together with the brave determination to ...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2010-09-01 00:00:00
abstract::Primary renal non-Hodgkin's lymphoma is very rare in childhood. A six-year-old boy presented with bilateral non-obstructive multinodular nephromegaly and renal failure. Percutaneous needle biopsy showed large-cell lymphoma. The patient was started on chemotherapy. A right nephrectomy was done when systemic hypertensio...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:Adiponectin, a novel adipocytokine with antiinflammatory and antiatherosclerosis properties, has been found to be an inverse predictor of cardiovascular outcomes among uremic patients on hemodialysis. However, its role in uremic patients on continuous ambulatory peritoneal dialysis (CAPD) remains unclear. Th...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2008-09-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2008-01-01 00:00:00
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journal_title:Journal of nephrology
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
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更新日期:1999-05-01 00:00:00
abstract::Hyperlipidaemia complicating the nephrotic syndrome is characterised by elevated levels of total and LDL cholesterol, often with hypertriglyceridaemia and low HDL cholesterol levels. The underlying mechanisms are complex but involve abnormalities of both lipoprotein synthesis and catabolism. Experience to date suggest...
journal_title:Journal of nephrology
pub_type: 杂志文章,评审
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更新日期:2001-11-01 00:00:00
abstract::To determine the clinical impact of conversion from C0 to C2 Neoral monitoring, we conducted a 6-month prospective study in 62 stable renal transplant recipients. Neoral was given alone (19%), with steroids (31%), combined with azathioprine (Aza) or mycophenolate mofetil (MMF) (50%). C0 and C2 target ranges were, resp...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2004-03-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章,评审
doi:
更新日期:2001-11-01 00:00:00
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journal_title:Journal of nephrology
pub_type: 杂志文章
doi:
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Gut-derived uremic toxins have been associated with adverse outcomes in chronic kidney disease (CKD). Alterations in bowel habits, including constipation, seem to play an additional role in uremic toxicity. The aim of this study is to investigate the association of bowel habits with gut-derived uremic toxins...
journal_title:Journal of nephrology
pub_type: 杂志文章
doi:10.1007/s40620-020-00819-9
更新日期:2020-10-01 00:00:00
abstract::Patients with chronic kidney disease (CKD) have a greatly enhanced risk of cardiovascular morbidity and mortality. Over the past decade it has come clear that a disturbed calcium-phosphate metabolism, with Fibroblast Growth Factor-23 as a key hormone, is partly accountable for this enhanced risk. Numerous studies have...
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更新日期:2020-10-01 00:00:00