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dc.contributor.authorCooper B.A.en
dc.contributor.authorCollins J.F.en
dc.contributor.authorBranley P.en
dc.contributor.authorCraig J.C.en
dc.contributor.authorFraenkel M.B.en
dc.contributor.authorJohnson D.W.en
dc.contributor.authorKesselhut J.en
dc.contributor.authorLuxton G.en
dc.contributor.authorPilmore A.en
dc.contributor.authorRosevear M.en
dc.contributor.authorTiller D.J.en
dc.contributor.authorPollock C.A.en
dc.contributor.authorHarris D.C.en
dc.contributor.authorHarris A.en
dc.contributor.authorLi J.J.en
dc.contributor.authorBulfone L.en
dc.date.accessioned2021-05-14T10:15:45Zen
dc.date.available2021-05-14T10:15:45Zen
dc.date.copyright2011en
dc.date.created20110429en
dc.date.issued2012-10-04en
dc.identifier.citationAmerican Journal of Kidney Diseases. 57 (5) (pp 707-715), 2011. Date of Publication: May 2011.en
dc.identifier.issn0272-6386en
dc.identifier.urihttps://repository.monashhealth.org/monashhealthjspui/handle/1/30358en
dc.description.abstractBackground: Planned early initiation of dialysis therapy based on estimated kidney function does not influence mortality and major comorbid conditions, but amelioration of symptoms may improve quality of life and decrease costs. Study Design: Patients with progressive chronic kidney disease and a Cockcroft-Gault estimated glomerular filtration rate of 10-15 mL/min/1.73 m2 were randomly assigned to start dialysis therapy at a glomerular filtration rate of either 10-14 (early start) or 5-7 mL/min/1.73 m2 (late start). Setting & Population: Of the original 828 patients in the IDEAL (Initiation of Dialysis Early or Late) Trial in renal units in Australia and New Zealand, 642 agreed to participate in this cost-effectiveness study. Study Perspective & Timeframe: A societal perspective was taken for costs. Patients were enrolled between July 1, 2000, and November 14, 2008, and followed up until November 14, 2009. Intervention(s): Planned earlier start of maintenance dialysis therapy. Outcome(s): Difference in quality of life and costs. Result(s): Median follow-up of patients (307 early start, 335 late start) was 4.15 years, with a 6-month difference in median duration of dialysis therapy. Mean direct dialysis costs were significantly higher in the early-start group ($10,777; 95% CI, $313 to $22,801). Total costs, including costs for resources used to manage adverse events, were higher in the early-start group ($18,715; 95% CI, -$3,162 to $43,021), although not statistically different. Adjusted for differences in baseline quality of life, the difference in quality-adjusted survival between groups over the time horizon of the trial was not statistically different (0.02 full health equivalent years; 95% CI, -0.09 to 0.14). Limitation(s): Missing quality-of-life questionnaires and skewed cost data, although similar in each group, decrease the precision of results. Conclusion(s): Planned early initiation of dialysis therapy in patients with progressive chronic kidney disease has higher dialysis costs and is not associated with improved quality of life. © 2011 National Kidney Foundation, Inc.en
dc.languageEnglishen
dc.languageenen
dc.publisherW.B. Saunders (Independence Square West, Philadelphia PA 19106-3399, United States)en
dc.titleCost-effectiveness of initiating dialysis early: A randomized controlled trial.en
dc.typeArticleen
dc.type.studyortrialRandomised controlled trial-
dc.identifier.doihttp://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1053/j.ajkd.2010.12.018en
dc.publisher.placeUnited Statesen
dc.identifier.pubmedid21349618 [http://www.ncbi.nlm.nih.gov/pubmed/?term=21349618]en
dc.identifier.source51289579en
dc.identifier.institution(Harris, Li, Bulfone) Centre for Health Economics, Bldg 75, Monash University, Clayton, VIC 3800, Australia (Cooper, Kesselhut, Pollock) Department of Renal Medicine, University of Sydney, Royal North Shore Hospital, Sydney, Australia (Bulfone) School of Health and Social Development, Deakin University, Burwood, Australia (Branley) Monash Medical Centre, Eastern Health Renal Units, Melbourne, Australia (Collins, Pilmore) Department of Medicine, University of Auckland, Auckland City Hospital, Auckland, New Zealand (Craig) Department of Nephrology, University of Sydney, Children's Hospital at Westmead, Sydney, Australia (Fraenkel) Department of Renal Medicine, Austin Hospital, Heidelberg, Australia (Johnson) Centre for Kidney Disease Research, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia (Luxton) Department of Nephrology, Prince of Wales Hospital, University of New South Wales, Sydney, Australia (Rosevear) Outome Management Services, Paremata, Wellington, New Zealand (Tiller) School of Rural Health, Sydney Medical School, University of Sydney, Sydney, Australia (Harris) Centre for Transplantation and Renal Research, Westmead Millennium Institute, University of Sydney, Sydney, Australiaen
dc.description.addressA. Harris, Centre for Health Economics, Bldg 75, Monash University, Clayton, VIC 3800, Australia. E-mail: anthony.harris@monash.eduen
dc.description.publicationstatusEmbaseen
dc.rights.statementCopyright 2012 Elsevier B.V., All rights reserved.en
dc.subect.keywordsChronic kidney disease cost cost-effectiveness dialysis economic evaluation quality of life randomizeden
dc.identifier.authoremailHarris A.; anthony.harris@monash.eduen
item.fulltextNo Fulltext-
item.cerifentitytypePublications-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.grantfulltextnone-
item.openairetypeArticle-
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