ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2015
Economics of dialysis dependence following renal replacement therapy for critically ill acute kidney injury patients.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Health Economic Evaluations in Intensive Care: An Updated Systematic Review.Critical care explorations · 2025Pooled it
- Biomarkers for assessing acute kidney injury for people who are being considered for admission to critical care: a systematic review and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2022Pooled it
- Point-of-care creatinine tests to assess kidney function for outpatients requiring contrast-enhanced CT imaging: systematic reviews and economic evaluation.Health technology assessment (Winchester, England) · 2020Pooled it
- Initiation of continuous renal replacement therapy versus intermittent hemodialysis in critically ill patients with severe acute kidney injury: a secondary analysis of STARRT-AKI trial.Intensive care medicine · 2023Trial
- Trial
- Building and Prospectively Evaluating a Prediction Model to Forecast Urgent Dialysis Needs across Four Tertiary Hospitals.American journal of nephrology · 2025Article
- Renal replacement therapy in an intensive care unit: guidelines from the SRLF-GFRUP consensus conference.Annals of intensive care · 2025Review
- Association of hospital-level continuous kidney replacement therapy use and mortality in critically ill patients with acute kidney injury.Intensive care medicine · 2025Article
- Cost-Utility Analysis of Renal Replacement Therapy Modalities in the Management of Severe Acute Kidney Injury in US Critically Ill Patients.ClinicoEconomics and outcomes research : CEOR · 2025Article
- Economic Analysis of Renal Replacement Therapy Modality in Acute Kidney Injury Patients With Fluid Overload.Critical care explorations · 2023Article
- Dialysis resource allocation in critical care: the impact of the COVID-19 pandemic and the promise of big data analytics.Frontiers in nephrology · 2023Review
- Early Albumin Infusion Is Associated With Greater Survival to Discharge Among Patients With Sepsis/Septic Shock Who Develop Severe Acute Kidney Injury Among Patients With Sepsis/Septic Shock Who Develop Severe Acute Kidney Injury.Critical care explorations · 2022Article
- A study protocol for improving the delivery of acute kidney replacement therapy (KRT) to critically ill patients in Alberta - DIALYZING WISELY.BMC nephrology · 2022Article
- Renal outcomes according to renal replacement therapy modality and treatment protocol in the ATN and RENAL trials.Critical care (London, England) · 2022Article
- Impact of Renal Replacement Therapy on Mortality and Renal Outcomes in Critically Ill Patients with Acute Kidney Injury: A Population-Based Cohort Study in Korea between 2008 and 2015.Journal of clinical medicine · 2022Article
- Cost-effectiveness of the TherMax blood warmer during continuous renal replacement therapy.PloS one · 2022Article
- A preliminary cost-effectiveness analysis of lung protective ventilation with extra corporeal carbon dioxide removal (ECCOJournal of critical care · 2021Article
- The future of critical care: renal support in 2027.Critical care (London, England) · 2017Review
- Effects of continuous and intermittent renal replacement therapies among adult patients with acute kidney injury.GMS health technology assessment · 2017Article
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe obective of this study was to perform a cost-effectiveness analysis comparing intermittent with continuous renal replacement therapy (IRRT versus CRRT) as initial therapy for acute kidney injury (AKI) in the intensive care unit (ICU).
methodsAssuming some patients would potentially be eligible for either modality, we modeled life year gained, the quality-adjusted life years (QALYs) and healthcare costs for a cohort of 1000 IRRT patients and a cohort of 1000 CRRT patients. We used a 1-year, 5-year and a lifetime horizon. A Markov model with two health states for AKI survivors was designed: dialysis dependence and dialysis independence. We applied Weibull regression from published estimates to fit survival curves for CRRT and IRRT patients and to fit the proportion of dialysis dependence among CRRT and IRRT survivors. We then applied a risk ratio reported in a large retrospective cohort study to the fitted CRRT estimates in order to determine the proportion of dialysis dependence for IRRT survivors. We conducted sensitivity analyses based on a range of differences for daily implementation cost between CRRT and IRRT (base case: CRRT day $632 more expensive than IRRT day; range from $200 to $1000) and a range of risk ratios for dialysis dependence for CRRT as compared with IRRT (from 0.65 to 0.95; base case: 0.80).
resultsContinuous renal replacement therapy was associated with a marginally greater gain in QALY as compared with IRRT (1.093 versus 1.078). Despite higher upfront costs for CRRT in the ICU ($4046 for CRRT versus $1423 for IRRT in average), the 5-year total cost including the cost of dialysis dependence was lower for CRRT ($37 780 for CRRT versus $39 448 for IRRT on average). The base case incremental cost-effectiveness analysis showed that CRRT dominated IRRT. This dominance was confirmed by extensive sensitivity analysis.
conclusionsInitial CRRT is cost-effective compared with initial IRRT by reducing the rate of long-term dialysis dependence among critically ill AKI survivors.
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Registered trials
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