Economic Effects of Treatment of Chronic Kidney Disease with Low-Protein Diet

20 Pages Posted: 12 Oct 2013

See all articles by Francesco Mennini

Francesco Mennini

University of Rome Tor Vergata - Centre for International Studies on Economic Growth (CEIS); Kingston University - School of Accounting and Finance

Simone Russo

University of Rome Tor Vergata - Centre for International Studies on Economic Growth (CEIS)

Andrea Marcellusi

University of Rome Tor Vergata - Centre for International Studies on Economic Growth (CEIS); University of Rome I

Giuseppe Quintaliani

Silvestrini Hospital - Departments of Nephrology Dialysis and Cardiology

Denis Fouque

Universidad de León - Center for European Nutrition and Safety

Date Written: October 10, 2013

Abstract

Background: Several clinical studies have shown that a low protein diet in patients with Chronic Kidney Disease (CKD), delays the natural progression of the end stage renal disease (ESRD) and the necessary treatment of chronic dialysis. The aim of this study is to estimate the cost-effectiveness of a low protein diet compared with no dietary treatment in patients with CKD stage 4 and 5 after 2, 3, 5 and 10 years.

Methods: A Markov model was developed to estimate costs and QALYs associated with low protein diet versus no treatment for patients with CKD stage 4-5. The transition probability was estimated on data from seven studies which determined the efficacy of low protein diets in delaying the need to start maintenance dialysis. The Quality Adjusted Life Years (QALYs) scores used were estimated with the Time Trade Off technique. The annual cost of dialysis per patient was estimated to be approximately €34,072. The costs of a low-protein diet was €1,440 per patient per year in the Lazio Region (conservative assumptions).

Results: Treatment with a low-protein diet was more effective in terms of QALYs: the difference was always in favour of dietary treatment from a 0.09 QALYS after the first two years, 0.16 after three years, 0.36 after five years and up to a differential of 0.93 year after the first 10 years of treatment. In terms of cost-effectiveness, the dietary treatment was always dominant in all intervals considered. The dominance is due to the fact that the treatment is more effective in terms of QALYs and at the same time is less expensive.

Conclusion The results of these simulations indicate that the treatment of CKD patients with a low protein diet is cost effective relative to no-treatment in an Italian setting. Further studies should test this model in other countries with different dialysis costs and dietary support.

Suggested Citation

Mennini, Francesco and Russo, Simone and Marcellusi, Andrea and Quintaliani, Giuseppe and Fouque, Denis, Economic Effects of Treatment of Chronic Kidney Disease with Low-Protein Diet (October 10, 2013). CEIS Working Paper No. 292, Available at SSRN: https://ssrn.com/abstract=2338432 or http://dx.doi.org/10.2139/ssrn.2338432

Francesco Mennini (Contact Author)

University of Rome Tor Vergata - Centre for International Studies on Economic Growth (CEIS) ( email )

Via Columbia, 2
Rome, I-00133
Italy

Kingston University - School of Accounting and Finance ( email )

United Kingdom

Simone Russo

University of Rome Tor Vergata - Centre for International Studies on Economic Growth (CEIS) ( email )

Via Columbia, 2
Rome, I-00133
Italy

Andrea Marcellusi

University of Rome Tor Vergata - Centre for International Studies on Economic Growth (CEIS) ( email )

Via Columbia, 2
Rome, I-00133
Italy

University of Rome I ( email )

Rome
Italy

Giuseppe Quintaliani

Silvestrini Hospital - Departments of Nephrology Dialysis and Cardiology ( email )

Perugia
Italy

Denis Fouque

Universidad de León - Center for European Nutrition and Safety ( email )

France

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