Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian Population
This real-world analysis evaluated the clinical and economic burden of non-dialysis-dependent CKD patients with and without secondary hyperparathyroidism (sHPT) in Italy. An observational retrospective study was conducted using administrative databases containing a pool of healthcare entities coveri...
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| Format: | Article |
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MDPI AG
2023-01-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/15/2/336 |
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| author | Simona Barbuto Valentina Perrone Chiara Veronesi Melania Dovizio Fulvia Zappulo Daniele Vetrano Sandro Giannini Maria Fusaro Domenica Daniela Ancona Antonietta Barbieri Fulvio Ferrante Fabio Lena Stefano Palcic Davide Re Francesca Vittoria Rizzi Paolo Cogliati Marco Soro Luca Degli Esposti Giuseppe Cianciolo |
| author_facet | Simona Barbuto Valentina Perrone Chiara Veronesi Melania Dovizio Fulvia Zappulo Daniele Vetrano Sandro Giannini Maria Fusaro Domenica Daniela Ancona Antonietta Barbieri Fulvio Ferrante Fabio Lena Stefano Palcic Davide Re Francesca Vittoria Rizzi Paolo Cogliati Marco Soro Luca Degli Esposti Giuseppe Cianciolo |
| author_sort | Simona Barbuto |
| collection | DOAJ |
| description | This real-world analysis evaluated the clinical and economic burden of non-dialysis-dependent CKD patients with and without secondary hyperparathyroidism (sHPT) in Italy. An observational retrospective study was conducted using administrative databases containing a pool of healthcare entities covering 2.45 million health-assisted individuals. Adult patients with hospitalization discharge diagnoses for CKD stages 3, 4, and 5 were included from 1 January 2012 to 31 March 2015 and stratified using the presence/absence of sHPT. Of the 5710 patients, 3119 were CKD-only (62%) and 1915 were CKD + sHPT (38%). The groups were balanced using Propensity Score Matching (PSM). Kaplan-Meier curves revealed that progression to dialysis and cumulative mortality had a higher incidence in the CKD + sHPT versus CKD-only group in CKD stage 3 patients and the overall population. The total direct healthcare costs/patient at one-year follow-up were significantly higher in CKD + sHPT versus CKD-only patients (EUR 8593 vs. EUR 5671, <i>p</i> < 0.001), mostly burdened by expenses for drugs (EUR 2250 vs. EUR 1537, <i>p</i> < 0.001), hospitalizations (EUR 4628 vs. EUR 3479, <i>p</i> < 0.001), and outpatient services (EUR 1715 vs. EUR 654, <i>p</i> < 0.001). These findings suggest that sHPT, even at an early CKD stage, results in faster progression to dialysis, increased mortality, and higher healthcare expenditures, thus indicating that timely intervention can ameliorate the management of CKD patients affected by sHPT. |
| first_indexed | 2024-03-09T11:31:38Z |
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| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-09T11:31:38Z |
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| spelling | doaj.art-7ca323cbbebf4935a70ce40a6ace378c2023-11-30T23:50:13ZengMDPI AGNutrients2072-66432023-01-0115233610.3390/nu15020336Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian PopulationSimona Barbuto0Valentina Perrone1Chiara Veronesi2Melania Dovizio3Fulvia Zappulo4Daniele Vetrano5Sandro Giannini6Maria Fusaro7Domenica Daniela Ancona8Antonietta Barbieri9Fulvio Ferrante10Fabio Lena11Stefano Palcic12Davide Re13Francesca Vittoria Rizzi14Paolo Cogliati15Marco Soro16Luca Degli Esposti17Giuseppe Cianciolo18Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyCliCon S.r.l., Società Benefit, Health, Economics & Outcomes Research, 40137 Bologna, ItalyCliCon S.r.l., Società Benefit, Health, Economics & Outcomes Research, 40137 Bologna, ItalyCliCon S.r.l., Società Benefit, Health, Economics & Outcomes Research, 40137 Bologna, ItalyNephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyNephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyClinica Medica 1, Department of Medicine, University of Padova, 35128 Padova, ItalyNational Research Council (CNR), Institute of Clinical Physiology (IFC), 56124 Pisa, ItalyPharmaceutical Department, ASL BAT (Barletta Andria Trani), 76123 Andria, ItalyDirettore SC Farmaceutica Territoriale, ASL VC, 13100 Vercelli, ItalyUOC Farmacia, Ufficio di Farmacovigilanza, ASL Frosinone, 03100 Frosinone, ItalyU.O.C. Politiche del Farmaco, USL Toscana Sud Est, 58100 Grosseto, ItalySC Farmacia Ospedaliera e Territoriale—Area Giuliana, Azienda Sanitaria Universitaria Integrata Giuliano-Isontina (ASUGI), 34128 Trieste, ItalyServizio Farmaceutico Territoriale, ASL Teramo, 64100 Teramo, ItalyPharmaceutical Department, ASL BAT (Barletta Andria Trani), 76123 Andria, ItalyCSL Vifor, 00142 Rome, ItalyCSL Vifor, 00142 Rome, ItalyCliCon S.r.l., Società Benefit, Health, Economics & Outcomes Research, 40137 Bologna, ItalyNephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyThis real-world analysis evaluated the clinical and economic burden of non-dialysis-dependent CKD patients with and without secondary hyperparathyroidism (sHPT) in Italy. An observational retrospective study was conducted using administrative databases containing a pool of healthcare entities covering 2.45 million health-assisted individuals. Adult patients with hospitalization discharge diagnoses for CKD stages 3, 4, and 5 were included from 1 January 2012 to 31 March 2015 and stratified using the presence/absence of sHPT. Of the 5710 patients, 3119 were CKD-only (62%) and 1915 were CKD + sHPT (38%). The groups were balanced using Propensity Score Matching (PSM). Kaplan-Meier curves revealed that progression to dialysis and cumulative mortality had a higher incidence in the CKD + sHPT versus CKD-only group in CKD stage 3 patients and the overall population. The total direct healthcare costs/patient at one-year follow-up were significantly higher in CKD + sHPT versus CKD-only patients (EUR 8593 vs. EUR 5671, <i>p</i> < 0.001), mostly burdened by expenses for drugs (EUR 2250 vs. EUR 1537, <i>p</i> < 0.001), hospitalizations (EUR 4628 vs. EUR 3479, <i>p</i> < 0.001), and outpatient services (EUR 1715 vs. EUR 654, <i>p</i> < 0.001). These findings suggest that sHPT, even at an early CKD stage, results in faster progression to dialysis, increased mortality, and higher healthcare expenditures, thus indicating that timely intervention can ameliorate the management of CKD patients affected by sHPT.https://www.mdpi.com/2072-6643/15/2/336chronic kidney diseasesecondary hyperparathyroidismreal-world evidenceCKD-MBD (Chronic Kidney Disease-Mineral Bone Disorder)native vitamin Dactive vitamin D |
| spellingShingle | Simona Barbuto Valentina Perrone Chiara Veronesi Melania Dovizio Fulvia Zappulo Daniele Vetrano Sandro Giannini Maria Fusaro Domenica Daniela Ancona Antonietta Barbieri Fulvio Ferrante Fabio Lena Stefano Palcic Davide Re Francesca Vittoria Rizzi Paolo Cogliati Marco Soro Luca Degli Esposti Giuseppe Cianciolo Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian Population Nutrients chronic kidney disease secondary hyperparathyroidism real-world evidence CKD-MBD (Chronic Kidney Disease-Mineral Bone Disorder) native vitamin D active vitamin D |
| title | Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian Population |
| title_full | Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian Population |
| title_fullStr | Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian Population |
| title_full_unstemmed | Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian Population |
| title_short | Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian Population |
| title_sort | real world analysis of outcomes and economic burden in patients with chronic kidney disease with and without secondary hyperparathyroidism among a sample of the italian population |
| topic | chronic kidney disease secondary hyperparathyroidism real-world evidence CKD-MBD (Chronic Kidney Disease-Mineral Bone Disorder) native vitamin D active vitamin D |
| url | https://www.mdpi.com/2072-6643/15/2/336 |
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