Tags

Type your tag names separated by a space and hit enter

Economic Analysis of a Ketoanalogue-Supplemented Very Low-Protein Diet in Patients With Chronic Kidney Disease in Taiwan and Thailand.
J Ren Nutr. 2023 03; 33(2):269-277.JR

Abstract

OBJECTIVE

A vegetarian very low-protein diet (VLPD) supplemented with ketoanalogues of essential amino acids Ketoanalogue-supplemented very low-protein diet (sVLPD) delays dialysis initiation in patients with chronic kidney disease (CKD). In this cost-effectiveness analysis, we compare an sVLPD with a conventional low-protein diet (LPD) in patients with CKD stage 4-5 using data from Taiwan and Thailand.

DESIGN AND METHODS

A Markov model simulated health outcomes and care costs in patients receiving an sVLPD (0.3-0.4 g/kg-day, vegetarian diet) supplemented with ketoanalogues (1 tablet/5 kg-day) or an LPD (0.6 g/kg-day, mixed proteins). Health state transition probability and resource cost inputs were based on published literature and local sources, respectively.

RESULTS

An sVLPD increased survival and quality-adjusted life years (QALYs) at a lower cost than an LPD. Total cost of care in Taiwan was 2,262,592.30 New Taiwan dollars (NTD) (68,059.35 EUR) with an LPD and 1,096,938.20 NTD (32,996.18 EUR) with an sVLPD (difference -1,165,654.10 NTD; -35,063.17 EUR). Total cost of care in Thailand was 500,731.09 Thai baht (THB) (14,584.12 EUR) with an LPD and 421,019.22 THB (12,262.46 EUR) with an sVLPD (difference -79,711.86 THB; -2,321.66 EUR).

CONCLUSION

A ketoanalogue-supplemented vegetarian sVLPD increased QALYs and lowered lifetime care costs versus an LPD in patients with predialysis CKD in Taiwan and Thailand. These data, together with the new KDOQI Guidelines for nutrition in CKD, support dietary intervention using ketoanalogue-supplemented vegetarian sVLPDs to prevent CKD progression and postpone dialysis as a cost-effective approach, with beneficial effects for patients and health care providers.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Praditpornsilpa K
Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Electronic address: kearkiat@hotmail.com.
Garneata L
"Carol Davila" University of Medicine and Pharmacy, Dept of Internal Medicine and Nephrology, "Dr Carol Davila" Teaching Hospital of Nephrology, Bucharest, Romania.
Lin YC
Division of Nephrology, Department of Internal Medicine, School of Medicine, Taipei Medical University, Taipei Medical University Hospital, TMU Research Center of Urology and Kidney (TMU-RCUK), Taipei, Taiwan.
Povero M
AdRes, Health Economics and Outcome Research, Turin, Italy.
Pradelli L
AdRes, Health Economics and Outcome Research, Turin, Italy.
Susantitaphong P
Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Wu CH
Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.

MeSH

HumansDiet, Protein-RestrictedTaiwanThailandRenal Insufficiency, ChronicRenal DialysisCost-Benefit Analysis

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

36179957

Citation

Praditpornsilpa, Kearkiat, et al. "Economic Analysis of a Ketoanalogue-Supplemented Very Low-Protein Diet in Patients With Chronic Kidney Disease in Taiwan and Thailand." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 33, no. 2, 2023, pp. 269-277.
Praditpornsilpa K, Garneata L, Lin YC, et al. Economic Analysis of a Ketoanalogue-Supplemented Very Low-Protein Diet in Patients With Chronic Kidney Disease in Taiwan and Thailand. J Ren Nutr. 2023;33(2):269-277.
Praditpornsilpa, K., Garneata, L., Lin, Y. C., Povero, M., Pradelli, L., Susantitaphong, P., & Wu, C. H. (2023). Economic Analysis of a Ketoanalogue-Supplemented Very Low-Protein Diet in Patients With Chronic Kidney Disease in Taiwan and Thailand. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 33(2), 269-277. https://doi.org/10.1053/j.jrn.2022.09.004
Praditpornsilpa K, et al. Economic Analysis of a Ketoanalogue-Supplemented Very Low-Protein Diet in Patients With Chronic Kidney Disease in Taiwan and Thailand. J Ren Nutr. 2023;33(2):269-277. PubMed PMID: 36179957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Economic Analysis of a Ketoanalogue-Supplemented Very Low-Protein Diet in Patients With Chronic Kidney Disease in Taiwan and Thailand. AU - Praditpornsilpa,Kearkiat, AU - Garneata,Liliana, AU - Lin,Yen-Chung, AU - Povero,Massimiliano, AU - Pradelli,Lorenzo, AU - Susantitaphong,Paweena, AU - Wu,Che-Hsiung, Y1 - 2022/09/28/ PY - 2022/06/29/received PY - 2022/09/12/accepted PY - 2022/10/1/pubmed PY - 2023/3/28/medline PY - 2022/9/30/entrez KW - Chronic kidney disease KW - Cost-effectiveness analysis KW - Ketoanalogue supplementation KW - Low-protein diet KW - Taiwan and Thailand SP - 269 EP - 277 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 33 IS - 2 N2 - OBJECTIVE: A vegetarian very low-protein diet (VLPD) supplemented with ketoanalogues of essential amino acids Ketoanalogue-supplemented very low-protein diet (sVLPD) delays dialysis initiation in patients with chronic kidney disease (CKD). In this cost-effectiveness analysis, we compare an sVLPD with a conventional low-protein diet (LPD) in patients with CKD stage 4-5 using data from Taiwan and Thailand. DESIGN AND METHODS: A Markov model simulated health outcomes and care costs in patients receiving an sVLPD (0.3-0.4 g/kg-day, vegetarian diet) supplemented with ketoanalogues (1 tablet/5 kg-day) or an LPD (0.6 g/kg-day, mixed proteins). Health state transition probability and resource cost inputs were based on published literature and local sources, respectively. RESULTS: An sVLPD increased survival and quality-adjusted life years (QALYs) at a lower cost than an LPD. Total cost of care in Taiwan was 2,262,592.30 New Taiwan dollars (NTD) (68,059.35 EUR) with an LPD and 1,096,938.20 NTD (32,996.18 EUR) with an sVLPD (difference -1,165,654.10 NTD; -35,063.17 EUR). Total cost of care in Thailand was 500,731.09 Thai baht (THB) (14,584.12 EUR) with an LPD and 421,019.22 THB (12,262.46 EUR) with an sVLPD (difference -79,711.86 THB; -2,321.66 EUR). CONCLUSION: A ketoanalogue-supplemented vegetarian sVLPD increased QALYs and lowered lifetime care costs versus an LPD in patients with predialysis CKD in Taiwan and Thailand. These data, together with the new KDOQI Guidelines for nutrition in CKD, support dietary intervention using ketoanalogue-supplemented vegetarian sVLPDs to prevent CKD progression and postpone dialysis as a cost-effective approach, with beneficial effects for patients and health care providers. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/36179957/Economic_Analysis_of_a_Ketoanalogue_Supplemented_Very_Low_Protein_Diet_in_Patients_With_Chronic_Kidney_Disease_in_Taiwan_and_Thailand_ DB - PRIME DP - Unbound Medicine ER -