The health-economic impact of urine albumin-to-creatinine ratio testing for chronic kidney disease in Japanese non-diabetic patients

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2024年12月16日

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Tsuneo Konta,
Koichi Asahi,
Kouichi Tamura,
Fumitaka Tanaka,
Akira Fukui,
Yusuke Nakamura,
Junichi Hirose,
Kenichi Ohara,
Yoko Shijoh,
Matthew Carter,
Kimberley Meredith,
James Harris,
Örjan Åkerborg,
Naoki Kashihara,
Takashi Yokoo

摘要

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.