Evidence map›Paper›PMID 42149345›Full record

ArticleClinical and experimental nephrology2026

Cost-effectiveness of multidisciplinary care for patients with chronic kidney disease in Japan.

Hiromu Tomishima, Motoki Odawara, Tsuguru Hatta, Yoshihiko Imamura, Tsutomu Sakurada, Takashi Maruyama, Masanori Abe, Shinya Kaname, Masaomi Nangaku, Hiroshi Nishi

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Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hiromu TomishimaFaculty of Medicine, The University of Tokyo, Tokyo, Japan.
Motoki OdawaraDivision of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Tsuguru HattaDepartment of Medicine, Hatta Medical Clinic, Kyoto, Japan.
Yoshihiko ImamuraDepartment of Nephrology, Nissan Tamagawa Hospital, Tokyo, Japan.
Tsutomu SakuradaDivision of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
Takashi MaruyamaDivision of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Masanori AbeDivision of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Shinya KanameDepartment of Nephrology and Rheumatology, Kyorin University School of Medicine, Tokyo, Japan.
Masaomi NangakuDivision of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Hiroshi NishiDivision of Nephrology and Endocrinology, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. hrnishi-tky@umin.ac.jp.ORCID http://orcid.org/0000-0001-8415-7889

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultidisciplinary care (MDC), where a team of various health professionals provides guidance to patients, is an effective approach for chronic kidney disease (CKD) and has been reimbursed by Japanese public healthcare insurance in 2024. To sustainably achieve medical benefits with limited resources, we examined the cost-effectiveness of MDC in Japan.

methodsA Markov model from a healthcare system perspective was used to evaluate the cost-effectiveness of adding MDC to the standard treatment for CKD in Japan over lifetime. Each cohort with an initial CKD stage (G3a, G3b, and G4) was analyzed. The parameters were based on previous studies including Chronic Kidney Disease Japan Cohort study. An incremental cost-effectiveness ratio (ICER) of < 5,000,000 Japanese yen (JPY) per quality-adjusted life-year (QALY) was considered cost-effective. One-way deterministic analyses, probabilistic sensitivity analyses, and scenario analyses were conducted to ensure the robustness of the results.

resultsAdding MDC to the standard treatment for CKD decreased cost by 10.66 million, 8.42 million, 4.21 million JPY and increased utility by 9.52, 8.70, 7.17 QALYs in CKD G3a, G3b, and G4 cohort, respectively, suggesting that it was a dominant strategy. Sensitivity analyses showed that adding MDC was cost-effective in more than 99% of cases in all cohorts with an ICER threshold of 5,000,000 JPY. Scenario analyses, where smaller therapeutic effects of MDC were estimated, showed compatible results.

conclusionBased on our model, adding MDC to the standard treatment for CKD stages G3a, G3b, and G4, is highly likely to be a cost-effective strategy in Japanese healthcare system.

Indexed as

Health Care CostsPatient Care TeamRenal Insufficiency, ChronicCost-Benefit AnalysisCost-Effectiveness AnalysisHumansJapanMarkov ChainsModels, EconomicQuality-Adjusted Life YearsTreatment OutcomeChronic kidney diseaseCost-effectivenessMultidisciplinary care

Identifiers

PMID42149345
PMCPMC13379473

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.