Burden of illness for patients with non-dialysis chronic kidney disease and anemia in the United States: review of the literature.
OBJECTIVE
To assess the health-related quality of life (HRQL) and economic burden of chronic kidney disease (CKD) related anemia in non-dialysis patients in the United States (US) via literature review.


METHODS
MEDLINE, EMBASE, PROQOLID, and Cochrane Library/Renal Group Resources were searched. Studies were appraised for patient populations, disease-specific versus generic HRQL assessments, and type and magnitude of health-related costs.


RESULTS
The treatment costs for CKD patients with anemia compared to those without anemia were significantly higher and were blunted but persistent after controlling for comorbidities and confounders. Intervention with erythropoiesis stimulating agents (ESA) decreased anemia and avoided hospital admissions. Costs were higher when anemia was poorly controlled or untreated. HRQL burden was mainly due to physical limitations and difficulty in ability to perform activities of daily living. Significant positive correlations between increases in hemoglobin levels and HRQL measures were reported.


CONCLUSIONS
Although evidence is limited, the economic and HRQL burden of non-dialysis CKD-related anemia is substantial. Under-treatment of anemia may contribute to higher resource consumption and higher costs; however, patient co-morbidities, use of erythropoietin-stimulating agents, and overall management introduce potential confounds. The contribution of anemia to humanistic disease burden is due to a constellation of factors, including physical activity and functional status.
van Nooten
Floortje E
FE
Centre for Health Economics & Science Policy, United BioSource Corporation, 20 Bloomsbury Square, London, UK. Floortje.VanNooten@unitedbiosource.com
Green
Julia
J
Brown
Ruth
R
Finkelstein
Fredric O
FO
Wish
Jay
J
D000740:Anemia / Q000191:economics* / Q000209:etiology* / Q000523:psychology; D003365:Costs and Cost Analysis; D006397:Hematinics / Q000191:economics; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000191:economics* / Q000523:psychology; D011788:Quality of Life; D014481:United States
D006397:Hematinics