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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: 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
Authors: Barbuto, Simona; Perrone, Valentina; Veronesi, Chiara; Dovizio, Melania; Zappulo, Fulvia; Vetrano, Daniele; Giannini, Sandro; Fusaro, Maria; Ancona, Domenica Daniela; Barbieri, Antonietta; Ferrante, Fulvio; Lena, Fabio; Palcic, Stefano; Re, Davide; Rizzi, Francesca Vittoria; Cogliati, Paolo; Soro, Marco; Esposti, Luca Degli; Cianciolo, Giuseppe
Contributors: Barbuto, Simona; Perrone, Valentina; Veronesi, Chiara; Dovizio, Melania; Zappulo, Fulvia; Vetrano, Daniele; Giannini, Sandro; Fusaro, Maria; Ancona, Domenica Daniela; Barbieri, Antonietta; Ferrante, Fulvio; Lena, Fabio; Palcic, Stefano; Re, Davide; Rizzi, Francesca Vittoria; Cogliati, Paolo; Soro, Marco; Esposti, Luca Degli; Cianciolo, Giuseppe
Publisher Information: MDPI
Publication Year: 2023
Collection: Padua Research Archive (IRIS - Università degli Studi di Padova)
Subject Terms: CKD-MBD (Chronic Kidney Disease-Mineral Bone Disorder); active vitamin D; chronic kidney disease; native vitamin D; real-world evidence; secondary hyperparathyroidism
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, p < 0.001), mostly burdened by expenses for drugs (EUR 2250 vs. EUR 1537, p < 0.001), hospitalizations (EUR 4628 vs. EUR 3479, p < 0.001), and outpatient services (EUR 1715 vs. EUR 654, p < 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.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/36678208; info:eu-repo/semantics/altIdentifier/wos/WOS:000927538100001; volume:15; issue:2; firstpage:336; journal:NUTRIENTS; https://hdl.handle.net/11577/3474526
DOI: 10.3390/nu15020336
Availability: https://hdl.handle.net/11577/3474526; https://doi.org/10.3390/nu15020336
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.785EB5B2
Database: BASE