Progression and Treatment Cost of Patients with Chronic Kidney Disease - การดำเนินโรคและค่าใช้จ่ายในการรักษาของผู้ป่วยโรคไตเรื้อรัง

Abstract

This study was a retrospective cohort study using data extracted from electronic medical records
in Khueang Nai Hospital, Ubon Ratchathani. Participants were patients diagnosed with chronic
kidney disease (CKD)between 1 October 2006 and 30 September 2011. Patients who hadglomerular
filtration rate (GFR) less than 60 ml/min/1.73 m2 in two separate serum creatinine were included.
GFR was estimated using the Modification of Diet in Renal Disease (MDRD). The objective of this
study was to determine the progression and treatment costs in CKD patient. Kaplan-Meier plots and
generalized linear models were used for analyses. There were 2,336 patients, 59.5 percent were
female and mean age was 73.9, (10.9) years. At the end of a three-year follow up, 30 percent of CKD
stage 3 patients developed stage 4 and 38 percent of stage 4 patients developed stage 5. Cost of
treatment in fiscal year 2007 were 1,412 Baht per patient-year and increasing to 2,390 Baht per
patient-year in fiscal year 2011. The cost increased gradually 18 percent per year.Drug cost was the
main proportion of treatment cost. Factors that seemed to be associated with treatment cost were
male has 2.47 times higher cost of treatment than that of female (p 0.001), diabetes patients had
8.76 times higher cost of treatment than non diabetes patients (p<0.001) and CKD stage 4 has 4.27
times higher cost of treatment than CKD stage 3 (p<0.001). In conclusion, this study indicates that
disease progression was still rapid and hence impacted on cost of treatment. Further implementations
on intervention aiming to slow the progression of patients with CKD should be conducted.
Key words: chronic kidney disease, progression, cost