Is screening for chronic kidney disease cost effective?

January 01, 0001

Is screening for chronic kidney disease cost effective?

These Canadian researchers sought to determine the cost effectiveness of population based screening for chronic kidney disease using estimated glomerular filtration rate. They performed a cost utility analysis of screening alone compared to no screening stratified by age, presence or absence of diabetes, and the presence or absence of proteinuria, in the Canadian healthcare system. They utilized a large population based laboratory cohort used to estimate mortality rates and incidence of end stage renal disease.

The researchers found: "Compared with no screening, population based screening for chronic kidney disease was associated with an incremental cost of $C463 (Canadian dollars in 2009, equivalent to about £275, €308, US $382) and a gain of 0.0044 quality adjusted life years (QALYs) per patient overall, representing a cost per QALY gained of $C104,900. In a cohort of 100,000 people, screening for chronic kidney disease would be expected to reduce the number of people who develop end stage renal disease over their lifetime from 675 to 657. In subgroups of people with and without diabetes, the cost per QALY gained was $C22,600 and $C572,000, respectively. In a cohort of 100,000 people with diabetes, screening would be expected to reduce the number of people who develop end stage renal disease over their lifetime from 1796 to 1741. In people without diabetes with and without hypertension, the cost per QALY gained was $C334,000 and $C1,411,100, respectively."

The researchers concluded: "Population based screening for chronic kidney disease with assessment of estimated glomerular filtration rate is not cost effective overall or in subgroups of people with hypertension or older people. Targeted screening of people with diabetes is associated with a cost per QALY that is similar to that accepted in other interventions funded by public healthcare systems."

Screening for chronic kidney disease does not appear to be cost effective outside of diabetic patients.

For the full abstract, click here.

BMJ 341:c5869, 8 November 2010 © 2010 Manns et al.
Population based screening for chronic kidney disease: cost effectiveness study. Braden Manns, Brenda Hemmelgarn, Marcello Tonelli, et al. Correspondence to B Manns: [email protected]

Category: U. Urinary System. Keywords: chronic kidney disease, glomerular filtration rate, screening, cost effectiveness, population based screening, cost utility analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 30 November 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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