尿白蛋白与肌酐比值检测对日本非糖尿病患者慢性肾脏病的健康经济影响
The health-economic impact of urine albumin-to-creatinine ratio testing for chronic kidney disease in Japanese non-diabetic patients.
作者信息
Konta Tsuneo, Asahi Koichi, Tamura Kouichi, Tanaka Fumitaka, Fukui Akira, Nakamura Yusuke, Hirose Junichi, Ohara Kenichi, Shijoh Yoko, Carter Matthew, Meredith Kimberley, Harris James, Åkerborg Örjan, Kashihara Naoki, Yokoo Takashi
机构信息
Department of Public Health and Hygiene, Yamagata University Graduate School of Medicine, Yamagata, Japan.
Division of Nephrology and Hypertension, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan.
出版信息
Clin Exp Nephrol. 2025 May;29(5):583-595. doi: 10.1007/s10157-024-02600-9. Epub 2024 Dec 16.
BACKGROUND
The objective of this analysis was to estimate the clinical and economic impact of undertaking urine albumin-to-creatinine ratio (UACR) testing alongside regular estimated glomerular filtration rate testing for chronic kidney disease in non-diabetic Japanese patients versus no testing and versus urine protein-creatinine ratio (UPCR) testing.
METHODS
An economic model, taking a Japanese healthcare perspective, estimated the health-economic impact of UACR testing over a lifetime time horizon. Outcomes reported were additional costs, clinical benefits measured, such as prevented dialyses and cardiovascular events, quality-adjusted life years gained, and incremental cost-effectiveness ratios. Health states were derived from risk levels reported in the Kidney Disease: Improving Global Outcomes heatmap. Results were derived assuming that after testing, treatment was available in the form of current standard-of-care or emerging chronic kidney disease therapies.
RESULTS
Repeated UACR testing was found to be cost-effective compared to both no urine testing and UPCR testing, with incremental cost-effectiveness ratios of ¥1,953,958 and ¥1,966,433, respectively.
CONCLUSION
Overall, this model demonstrates the health-economic value of undertaking UACR testing within the non-diabetic Japanese population.
背景
本分析的目的是评估对于非糖尿病日本患者，在进行常规估算肾小球滤过率检测的同时开展尿白蛋白与肌酐比值（UACR）检测，相较于不进行检测以及相较于尿蛋白与肌酐比值（UPCR）检测，所产生的临床和经济影响。
方法
采用日本医疗保健视角的经济模型，估算了UACR检测在整个生命周期内的健康经济影响。报告的结果包括额外成本、所衡量的临床益处（如预防的透析和心血管事件）、获得的质量调整生命年以及增量成本效益比。健康状态源自《改善全球肾脏病预后》热图中报告的风险水平。假设检测后可采用当前标准治疗或新兴的慢性肾脏病疗法进行治疗，从而得出结果。
结果
与不进行尿液检测和UPCR检测相比，重复进行UACR检测具有成本效益，增量成本效益比分别为1,953,958日元和1,966,433日元。
结论
总体而言，该模型证明了在非糖尿病日本人群中开展UACR检测的健康经济价值。
Zotero 插件