Screen-and-treat strategies for albuminuria to prevent cardiovascular and renal disease: cost-effectiveness of nationwide and targeted interventions based on analysis of cohort data from the Netherlands

Clinical Therapeutics
Cornelis BoersmaPrevention of Renal and Vascular End Stage Disease Study Group

Abstract

Albuminuria is a marker for renal and cardiovascular (CV) risk, allowing early diagnosis of subjects with elevated renal and CV risk. This study aimed to estimate the cost-effectiveness and budget impact of various population-based screen-and-treat scenarios for elevated albuminuria levels (ie, microalbuminuria) in the Netherlands. A multistate transition Markov model was developed to simulate the natural course of albuminuria-based disease progression to dialysis and occurrence of CV events. Several population-based strategies directed at screening for elevated albuminuria were evaluated. These strategies depended on urinary albumin concentration (UAC), urinary albumin excretion (UAE), and age. Transition probabilities were derived from the observational community-based Prevention of Renal and Vascular End Stage Disease (PREVEND) cohort study. Health care costs (in year-2008 euros) and life-years gained were calculated over an 8-year period. In the base-case analysis, we analyzed screening for and treatment of microalbuminuria. Screening for microalbuminuria involved prescreening for UAC >or=20 mg/L, followed by a confirmation test for UAE >or=30 mg/d. Other options based on combinations of albuminuria for UAC prescreening (no...Continue Reading

References

Mar 8, 1998·PharmacoEconomics·A Briggs, M Sculpher
Sep 8, 2000·PharmacoEconomics·A H Briggs
May 15, 2001·European Heart Journal·B A van Hout, M L Simoons
Sep 22, 2001·The New England Journal of Medicine·B M BrennerUNKNOWN RENAAL Study Investigators
Sep 22, 2001·The New England Journal of Medicine·H H ParvingUNKNOWN Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria Study Group
Oct 3, 2002·Circulation·Hans L HillegeUNKNOWN Prevention of Renal and Vascular End Stage Disease (PREVEND) Study Group
Dec 18, 2003·JAMA : the Journal of the American Medical Association·L Ebony BoulwareNeil R Powe
Apr 29, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·UNKNOWN Kidney Disease Outcomes Quality Initiative (K/DOQI)
Jul 3, 2004·BMJ : British Medical Journal·Jan P Vandenbroucke
Oct 16, 2004·Kidney International. Supplement·Jacobien C VerhaveUNKNOWN PREVEND Study Group
Oct 20, 2004·Circulation·Folkert W AsselbergsUNKNOWN Prevention of Renal and Vascular Endstage Disease Intervention Trial (PREVEND IT) Investigators
Aug 20, 2005·Kidney International. Supplement·Arrigo Schieppati, Giuseppe Remuzzi
Jan 26, 2006·Journal of the American Society of Nephrology : JASN·Auke H BrantsmaRonald T Gansevoort
May 30, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Seema Basi, Julia B Lewis
Jun 20, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Pantelis A Sarafidis, George L Bakris
Jul 11, 2006·Journal of the American Society of Nephrology : JASN·Paul E de Jong, Gary C Curhan
Oct 4, 2006·Hypertension·Luis M Ruilope, Julian Segura
Nov 8, 2007·JAMA : the Journal of the American Medical Association·Josef CoreshAndrew S Levey
Nov 23, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Bernard G JaarNeil R Powe
Feb 5, 2008·British Journal of Clinical Pharmacology·Cornelis BoersmaUNKNOWN PREVEND Study Group
Feb 22, 2008·Clinical Journal of the American Society of Nephrology : CJASN·Paul E de JongCarmine Zoccali
May 21, 2008·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Garry R BartonElisabeth A L Fenwick
May 7, 2009·JAMA : the Journal of the American Medical Association·Bakhtawar K MahmoodiUNKNOWN Prevention of Renal and Vascular End-stage Disease (PREVEND) Study Group
Feb 5, 2010·The American Journal of Cardiology·Björn Dahlöf

❮ Previous
Next ❯

Citations

Aug 13, 2010·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Akin ÖzyilmazUNKNOWN PREVEND Study Group
Nov 13, 2012·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Akin ÖzyilmazRonald T Gansevoort
Aug 27, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Akin ÖzyilmazUNKNOWN PREVEND Study Group
Feb 18, 2014·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Paul KomendaNavdeep Tangri
Jul 26, 2011·Advances in Chronic Kidney Disease·Deidra C CrewsBernard G Jaar
Sep 17, 2013·The Journal of Clinical Hypertension·Andrea G KattahVesna D Garovic
Aug 6, 2016·Journal of Nephrology·Veronica Agatha Lopes van BalenMarc Erich August Spaanderman
Oct 16, 2015·PloS One·Andrew J SuttonUNKNOWN eGFR-C study group
May 31, 2017·Nature Reviews. Nephrology·Raymond VanholderUNKNOWN European Kidney Health Alliance
May 23, 2018·European Journal of Gastroenterology & Hepatology·Karn WijarnpreechaWisit Cheungpasitporn
Oct 9, 2009·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·J ØyenG Haugeberg
Aug 31, 2010·Current Opinion in Nephrology and Hypertension·Ron T GansevoortStephan J L Bakker
Dec 18, 2010·Journal of the American Society of Nephrology : JASN·Paul E de Jong, Ron T Gansevoort
Apr 15, 2017·Journal of the American Society of Nephrology : JASN·Bernadette ThomasUNKNOWN Global Burden of Disease Genitourinary Expert Group
Aug 25, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Lipika Samal, Jeffrey A Linder
Jul 16, 2014·Journal of Hypertension·Miguel-Angel Sánchez-ChaparroUNKNOWN ICARIA (Ibermutuamur CArdiovascular RIsk Assessment) Study Group
Jun 15, 2013·Expert Review of Pharmacoeconomics & Outcomes Research·Sipke T VisserMaarten J Postma
Feb 11, 2015·Expert Review of Pharmacoeconomics & Outcomes Research·Thomas W FergusonPaul Komenda
Jan 4, 2017·European Journal of Public Health·Mickael HiligsmannDirk Ruwaard
May 18, 2019·Journal of the American Society of Nephrology : JASN·Rupert W MajorNigel J Brunskill
Apr 24, 2017·Kidney International·Thomas W FergusonPaul V J Komenda

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