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Reducing the costs of chronic kidney disease while delivering quality health care : a call to action

(2017) NATURE REVIEWS NEPHROLOGY. 13(7). p.393-409
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Abstract
The treatment of chronic kidney disease (CKD) and of end-stage renal disease (ESRD) imposes substantial societal costs. Expenditure is highest for renal replacement therapy (RRT), especially in-hospital haemodialysis. Redirection towards less expensive forms of RRT (peritoneal dialysis, home haemodialysis) or kidney transplantation should decrease financial pressure. However, costs for CKD are not limited to RRT, but also include nonrenal health-care costs, costs not related to health care, and costs for patients with CKD who are not yet receiving RRT. Even if patients with CKD or ESRD could be given the least expensive therapies, costs would decrease only marginally. We therefore propose a consistent and sustainable approach focusing on prevention. Before a preventive strategy is favoured, however, authorities should carefully analyse the cost to benefit ratio of each strategy. Primary prevention of CKD is more important than secondary prevention, as many other related chronic diseases, such as diabetes mellitus, hypertension, cardiovascular disease, liver disease, cancer, and pulmonary disorders could also be prevented. Primary prevention largely consists of lifestyle changes that will reduce global societal costs and, more importantly, result in a healthy, active, and long-lived population. Nephrologists need to collaborate closely with other sectors and governments, to reach these aims.
Keywords
RENAL REPLACEMENT THERAPY, ASSISTED PERITONEAL-DIALYSIS, CLINICAL-PRACTICE GUIDELINE, SIMVASTATIN PLUS EZETIMIBE, GLOMERULAR-FILTRATION-RATE, URINARY ALBUMIN EXCRETION, MODIFIABLE, LIFE-STYLE, SERVICES TASK-FORCE, LONG-TERM-CARE, CARDIOVASCULAR EVENTS

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Citation

Please use this url to cite or link to this publication:

Chicago
Vanholder, Raymond, Lieven Annemans, Edwina Brown, Ron Gansevoort, Judith J Gout-Zwart, Norbert Lameire, Rachael L Morton, et al. 2017. “Reducing the Costs of Chronic Kidney Disease While Delivering Quality Health Care : a Call to Action.” Nature Reviews Nephrology 13 (7): 393–409.
APA
Vanholder, R., Annemans, L., Brown, E., Gansevoort, R., Gout-Zwart, J. J., Lameire, N., Morton, R. L., et al. (2017). Reducing the costs of chronic kidney disease while delivering quality health care : a call to action. NATURE REVIEWS NEPHROLOGY, 13(7), 393–409.
Vancouver
1.
Vanholder R, Annemans L, Brown E, Gansevoort R, Gout-Zwart JJ, Lameire N, et al. Reducing the costs of chronic kidney disease while delivering quality health care : a call to action. NATURE REVIEWS NEPHROLOGY. 2017;13(7):393–409.
MLA
Vanholder, Raymond, Lieven Annemans, Edwina Brown, et al. “Reducing the Costs of Chronic Kidney Disease While Delivering Quality Health Care : a Call to Action.” NATURE REVIEWS NEPHROLOGY 13.7 (2017): 393–409. Print.
@article{8529568,
  abstract     = {The treatment of chronic kidney disease (CKD) and of end-stage renal disease (ESRD) imposes substantial societal costs. Expenditure is highest for renal replacement therapy (RRT), especially in-hospital haemodialysis. Redirection towards less expensive forms of RRT (peritoneal dialysis, home haemodialysis) or kidney transplantation should decrease financial pressure. However, costs for CKD are not limited to RRT, but also include nonrenal health-care costs, costs not related to health care, and costs for patients with CKD who are not yet receiving RRT. Even if patients with CKD or ESRD could be given the least expensive therapies, costs would decrease only marginally. We therefore propose a consistent and sustainable approach focusing on prevention. Before a preventive strategy is favoured, however, authorities should carefully analyse the cost to benefit ratio of each strategy. Primary prevention of CKD is more important than secondary prevention, as many other related chronic diseases, such as diabetes mellitus, hypertension, cardiovascular disease, liver disease, cancer, and pulmonary disorders could also be prevented. Primary prevention largely consists of lifestyle changes that will reduce global societal costs and, more importantly, result in a healthy, active, and long-lived population. Nephrologists need to collaborate closely with other sectors and governments, to reach these aims.},
  author       = {Vanholder, Raymond and Annemans, Lieven and Brown, Edwina and Gansevoort, Ron and Gout-Zwart, Judith J and Lameire, Norbert and Morton, Rachael L and Oberbauer, Rainer and Postma, Maarten J and Tonelli, Marcello and Van Biesen, Wim and Zoccali, Carmine},
  issn         = {1759-5061},
  journal      = {NATURE REVIEWS NEPHROLOGY},
  language     = {eng},
  number       = {7},
  pages        = {393--409},
  title        = {Reducing the costs of chronic kidney disease while delivering quality health care : a call to action},
  url          = {http://dx.doi.org/10.1038/nrneph.2017.63},
  volume       = {13},
  year         = {2017},
}

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