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2022年至2027年西班牙慢性肾脏病临床和经济负担预测:CKD内部项目结果

Projection of the clinical and economic burden of chronic kidney disease between 2022 and 2027 in Spain: Results of the Inside CKD project.

作者信息

Navarro González Juan F, Ortiz Alberto, Cebrián Cuenca Ana, Moreno Barón Marta, Segú Lluís, Pimentel Belén, Aranda Unai, Lopez-Chicheri Blanca, Capel Margarita, Pomares Mallol Elisenda, Caudron Christian, García Sánchez Juan José, Alcázar Arroyo Roberto

机构信息

Unidad de Investigación y Servicio de Nefrología, Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain; RICORS2040 (Kidney Disease), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Tecnologías Biomédicas, Universidad de La Laguna, Tenerife, Spain; Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.

Servicio de Nefrología e Hipertensión, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain.

出版信息

Nefrologia (Engl Ed). 2024 Nov-Dec;44(6):807-817. doi: 10.1016/j.nefroe.2024.11.009. Epub 2024 Dec 3.

Abstract

BACKGROUND AND OBJECTIVE

Chronic kidney disease (CKD) is a growing health problem affecting between 10% and 15% of the Spanish population. The lack of updated projections of the evolution of the disease burden hinders the development of evidence-based health policies and interventions to optimise the management of the disease and prevent its progression. The aim of this study is to project the evolution of the clinical and economic burden of CKD in Spain between 2022 and 2027.

MATERIALS AND METHODS

Inside CKD uses a validated microsimulation approach to project the burden of CKD. The projection is based on a virtual population according to Spanish demographics, literature, national data registries and clinical expert opinion. Costs associated with CKD management, renal replacement therapy (RRT), cardiovascular complications and arterial comorbidities were included.

RESULTS

In Spain, an absolute increase in the prevalence of CKD of 1% (from 10.7% to 11.7%) is expected between 2022 and 2027, corresponding to an increase from 5.14 million to 5.68 million patients in 2027. However, only one third of CKD patients would be diagnosed. Of these diagnosed patients, 3.9% will require RRT in 2027, an increase of 14.7% from 2022. A total of 654,281 accumulated deaths are expected in patients with CKD diagnosed between 2022 and 2027. The economic burden of diagnosed CKD is expected to increase by 13.8% to 4.89 billion euros in 2027, representing 5.56% of total Spanish public health expenditure in 2027 (compared to 4.88% in 2022), of which 42.5% will be allocated to RRT (2.4% of public health expenditure).

CONCLUSIONS

The Inside CKD project highlights the growing clinical, economic and social burden of CKD in Spain expected by 2027. Progression to more advanced stages with the need for RRT and associated complications represent a small proportion of the total CKD population, but contribute significantly to overall costs.

摘要

背景与目的

慢性肾脏病(CKD)是一个日益严重的健康问题,影响着10%至15%的西班牙人口。缺乏对疾病负担演变的最新预测阻碍了制定基于证据的卫生政策和干预措施,以优化疾病管理并预防其进展。本研究的目的是预测2022年至2027年西班牙CKD的临床和经济负担演变。

材料与方法

CKD内部模型采用经过验证的微观模拟方法来预测CKD的负担。该预测基于一个根据西班牙人口统计学、文献、国家数据登记处和临床专家意见构建的虚拟人群。纳入了与CKD管理、肾脏替代治疗(RRT)、心血管并发症和动脉合并症相关的成本。

结果

在西班牙,预计2022年至2027年间CKD患病率将绝对增加1%(从10.7%增至11.7%),这相当于2027年患者人数从514万增至568万。然而,仅有三分之一的CKD患者会被诊断出来。在这些被诊断出的患者中,2027年将有3.9%需要RRT,较2022年增加14.7%。预计2022年至2027年间被诊断出的CKD患者累计死亡654281人。2027年,被诊断出的CKD的经济负担预计将增加13.8%,达到48.9亿欧元,占2027年西班牙公共卫生总支出的5.56%(2022年为4.88%),其中42.5%将用于RRT(占公共卫生支出的2.4%)。

结论

CKD内部模型项目凸显了预计到2027年西班牙CKD日益加重的临床、经济和社会负担。进展到需要RRT及相关并发症的更晚期阶段的患者在CKD总人口中占比很小,但对总体成本有重大影响

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