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\n\u2028Braden Manns, et.al.:\u3000 Population based screening for chronic kidney disease: cost effectiveness study.BMJ 341:5869,2010.\u2028\u2028\u2028
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\n\u3010Objective\u3011
\n\u2028To determine the cost effectiveness of one-off population based screening for chronic kidney disease based on e-GFR. \u2028
\n\u3010Design\u3011
\n\u2028Cost utility analysis of screening with e-GFR alone compared with no screening. Analyses were stratified by age, diabetes, and the presence or absence of proteinuria. \u2028Scenario and sensitivity analyses, including probabilistic sensitivity analysis, were performed. Costs were estimated in all adults and in subgroups defined by age, diabetes, and hypertension. \u2028
\n\u3010Setting\u3011
\n\u2028Publicly funded Canadian healthcare system. \u2028
\n\u3010Participants\u3011
\n\u2028Large population based laboratory cohort used to estimate mortality rates and incidence of end stage renal disease for patients with chronic kidney disease over a five year follow-up period. Patients had not previously undergone assessment of GFR. \u2028
\n\u3010Main outcome measures\u3011
\n\u2028Lifetime costs, end stage renal disease, quality adjusted life years (QALYs) gained, and incremental cost per QALY gained. \u2028
\n\u3010Results\u3011
\n\u2028Compared with no screening, population based screening for chronic kidney disease was associated with an incremental cost of $C463 (Canadian dollars in 2009; equivalent to about \u00a3275, \u20ac308, US $382) and a gain of 0.0044 QALYs per patient overall, representing a cost per QALY gained of $C104\u2009900. \u2028In a cohort of 100\u2009000 people, screening for chronic kidney disease would be expected to reduce the number of people who develop end stage renal disease over their lifetime from 675 to 657.\u2028In subgroups of people with and without diabetes, the cost per QALY gained was $C22\u2009600 and $C572\u2009000, respectively. In a cohort of 100\u2009000 people with diabetes, screening would be expected to reduce the number of people who develop end stage renal disease over their lifetime from 1796 to 1741. \u2028In people without diabetes with and without hypertension, the cost per QALY gained was $C334\u2009000 and $C1\u2009411\u2009100, respectively.
\n\u2028\u3010Conclusions\u3011
\n \u2028Population based screening for chronic kidney disease with assessment of e-GRF is not cost effective overall or in subgroups of people with hypertension or older people.\u2028\u00a0Targeted screening of people with diabetes is associated with a cost per QALY that is similar to that accepted in other interventions funded by public healthcare systems.\u2028\u2028<\/p>\n
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