Choice of Hemodialysis Access in Older Adults: A Cost-Effectiveness Analysis

Clinical Journal of the American Society of Nephrology : CJASN
Rasheeda K HallCathleen S Colón-Emeric

Abstract

Although arteriovenous fistulas have been found to be the most cost-effective form of hemodialysis access, the relative benefits of placing an arteriovenous fistula versus an arteriovenous graft seem to be least certain for older adults and when placed preemptively. However, older adults' life expectancy is heterogeneous, and most patients do not undergo permanent access creation until after dialysis initiation. We evaluated cost-effectiveness of arteriovenous fistula placement after dialysis initiation in older adults as a function of age and life expectancy. Using a hypothetical cohort of patients on incident hemodialysis with central venous catheters, we constructed Markov models of three treatment options: (1) arteriovenous fistula placement, (2) arteriovenous graft placement, or (3) continued catheter use. Costs, utilities, and transitional probabilities were derived from existing literature. Probabilistic sensitivity analyses were performed by age group (65-69, 70-74, 75-79, 80-84, and 85-89 years old) and quartile of life expectancy. Costs, quality-adjusted life-months, and incremental cost-effectiveness ratios were evaluated for up to 5 years. The arteriovenous fistula option was cost effective compared with continued c...Continue Reading

References

Oct 30, 2001·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·M A LittleJ J Walshe
Oct 29, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Harold I FeldmanKenneth Brayman
Jan 30, 2004·Journal of the American Society of Nephrology : JASN·Kevan R PolkinghornePeter G Kerr
May 11, 2005·Kidney International·Charmaine E LokSarbjit V Jassal
Dec 2, 2005·Clinical Trials : Journal of the Society for Clinical Trials·Laura M DemberUNKNOWN DAC Study Group
Feb 1, 2007·Journal of Vascular Surgery·Miltos K LazaridesDimitrios N Staramos
Feb 7, 2007·Annals of Internal Medicine·Manjula KurellaGlenn M Chertow
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Anne M MurrayAlvin H Moss
Aug 21, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Haimanot WasseYijian Huang
Sep 18, 2009·Hemodialysis International·Robert N FoleyAllan J Collins
Sep 30, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Hui XueSteven M Brunelli
Oct 30, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Michael Allon, Charmaine E Lok
Jan 11, 2011·Journal of Vascular Surgery·Nicola SwindlehurstIain Macdougall
Sep 3, 2011·Journal of the American Geriatrics Society·Annalise N PhamCathleen S Colón-Emeric
Nov 18, 2011·Kidney International·Manjula Kurella TamuraAnn M O'Hare
Sep 1, 2012·Kidney International·Peter G BlakeMatthew J Oliver
Sep 15, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Amy W WilliamsUNKNOWN American Society of Nephrology Quality, and Patient Safety Task Force
Feb 2, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Charmaine E LokLouise Moist
May 29, 2013·Journal of the American Geriatrics Society·Mara A McAdams-DeMarcoDorry L Segev
Jul 3, 2013·Journal of the American Society of Nephrology : JASN·Ranil N DeSilvaAlexander S Goldfarb-Rumyantzev
Jul 3, 2013·Journal of the American Society of Nephrology : JASN·Ann M O'Hare
Nov 16, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Vanessa GrubbsKirsten L Johansen
Jan 10, 2014·Hemodialysis International·Tammy HodAlexander S Goldfarb-Rumyantzev
Feb 1, 2014·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Katharine L CheungManjula Kurella Tamura
Jun 28, 2014·Clinical Journal of the American Society of Nephrology : CJASN·Jane O Schell, Robert A Cohen
Jul 27, 2014·Journal of the American Society of Nephrology : JASN·Jay B Wish
Jul 27, 2014·Journal of the American Society of Nephrology : JASN·David A DrewDaniel E Weiner
Aug 15, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Jordan R CaseyAllison Tong
Jul 1, 2015·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Mae ThamerHeejung Bang
Sep 10, 2015·The Journal of Vascular Access·Ingemar Davidson, Maurizio Gallieni
Jan 14, 2016·The New England Journal of Medicine·Terri R Fried
Mar 5, 2016·Journal of General Internal Medicine·Erica S BreslauLouise C Walter
Jul 13, 2016·Clinical Journal of the American Society of Nephrology : CJASN·Karen Woo, Charmaine E Lok
Sep 9, 2016·Journal of the American Society of Nephrology : JASN·Robert S BrownAlexander S Goldfarb-Rumyantzev
Feb 2, 2017·Journal of the American Society of Nephrology : JASN·Robert R QuinnPietro Ravani

❮ Previous
Next ❯

Citations

May 8, 2018·Seminars in Dialysis·Candice Halinski, Holly M Koncicki
May 20, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Timmy Lee, Michael Allon
Apr 23, 2019·The Journal of Vascular Access·Nathan K ItogaMatthew W Mell
Jul 16, 2019·The International Journal of Artificial Organs·Ursula HadimeriBernd Stegmayr
Jul 12, 2019·International Health·Percy Herrera-AñazcoJ Jaime Miranda
Sep 14, 2019·The Journal of Vascular Access·Rita L McGill, Eduardo K Lacson
Nov 4, 2017·Seminars in Dialysis·Chance S DumaineRobert R Quinn
Nov 5, 2019·Biomechanics and Modeling in Mechanobiology·Sjeng QuickenWouter Huberts
Jun 6, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Peter C ThomsonRam Kasthuri
Oct 9, 2020·Seminars in Dialysis·Robert S Brown
Oct 4, 2020·BMC Nephrology·Raphaëlle SylvestreUNKNOWN French REIN registry
May 31, 2020·Journal of Vascular Surgery·Abhisekh MohapatraEfthymios D Avgerinos
Feb 15, 2021·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Beini LyuBrad C Astor
Mar 7, 2021·International Urology and Nephrology·Peiyun LiuChieh Suai Tan
Apr 16, 2021·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Kenneth J WoodsideRonald L Pisoni
May 12, 2021·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Mehmet Ali SungurAta Niyazi Ecevit
May 31, 2019·Journal of Vascular Surgery·Benjamin S BrookeRichard Nelson

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.