2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2006030289v1 17/12/3497    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lefebvre, P. Articles by Mody, S. H. Search for Related Content PubMed PubMed Citation Articles by Lefebvre, P. Articles by Mody, S. H.

Medical Costs of Untreated Anemia in Elderly Patients with Predialysis Chronic Kidney Disease

Patrick Lefebvre^*, Mei Sheng Duh, Sharon Buteau^*, Brahim Bookhart and Samir H. Mody

^* Groupe d’Analyse, Montréal, Québec, Canada; Analysis Group, Boston, Massachusetts; and Ortho Biotech Clinical Affairs, Bridgewater, New Jersey

Address correspondence to: Dr. Mei Sheng Duh, Analysis Group, Inc., 111 Huntington Avenue, 10th Floor, Boston, MA 02199. Phone: 617-425-8131; Fax: 617-425-8001; E-mail: mduh{at}analysisgroup.com

Received for publication March 29, 2006. Accepted for publication September 26, 2006.

The objective of this study was to quantify the incremental medical costs that are associated with untreated anemia among elderly patients with predialysis chronic kidney disease (CKD). An analysis of claims and laboratory data between January 1999 and February 2005 was conducted. Inclusion criteria were age 65 yr, two or more hemoglobin readings, one or more claims for CKD, and two or more GFR values of <60 ml/min per 1.73 m² (stages 3 to 5 CKD). Patients were excluded when they had cancer or lupus, had received organ transplantation, or were treated for anemia. An open-cohort design was used to classify patients’ observation periods into anemia and nonanemia. Both univariate and multivariate analyses were conducted to compare periods of anemia and nonanemia for average monthly medical costs; the latter was adjusted for age, gender, GFR, diabetes, hypertension, liver cirrhosis, coronary artery disease, myocardial infarction, and left ventricular hypertrophy. A subset analysis of patients with moderate CKD (stage 3) was conducted. A total of 2001 patients were identified. Untreated anemia was associated with a significant increase in medical costs, with an unadjusted incremental monthly cost of $1089 (P < 0.0001) and a cost ratio of 1.8:1 relative to nonanemia. After controlling for covariates, untreated anemia remained significantly associated with a cost increase (adjusted incremental monthly cost $503; cost ratio 1.4:1; P < 0.0001). Similar significant cost burden was observed in the subset of patients with moderate CKD. The retrospective observational design may be more susceptible to bias than a randomized, controlled trial. This large study, which was based on real-life practice data, demonstrated that untreated anemia in elderly patients with predialysis CKD was associated with a significant increase in medical costs.

This article has been cited by other articles:

				E. G. Neilson Baumol's Curse on Medicine J. Am. Soc. Nephrol., June 1, 2008; 19(6): 1049 - 1053. [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673