Background
Methods
Source population
Patient selection
Outcomes
Statistical analysis
Sensitivity analyses
Results
Patient disposition and characteristics
Baseline iPTH*, pg/mL | Total | ||||||
---|---|---|---|---|---|---|---|
< 75 | ≥ 75 – < 150 | ≥ 150 – ≤ 300 | > 300 – ≤ 600 | > 600 | > 800 | ||
N patients | 1217 | 1365 | 1690 | 1343 | 754 | 472 | 6369 |
Males, n (%) | 641 (53) | 809 (59) | 1019 (60) | 767 (57) | 394 (52) | 233 (49) | 3630 (57) |
Age, years | 63.6 (14.7) | 64.7 (14.1) | 64.2 (14.2) | 62.0 (14.8) | 58.2 (15.7) | 57.5 (15.6) | 63.0 (14.7) |
Dialysis vintage†, months | 43.9 (52.7) | 37.8 (47.2) | 40.9 (53.0) | 49.0 (62.2) | 66.5 (64.8) | 70.6 (64.9) | 45.5 (56.0) |
History, n (%) | |||||||
Diabetes | 352 (29) | 404 (30) | 447 (26) | 276 (21) | 102 (14) | 56 (12) | 1581 (25) |
CVD | 978 (80) | 1075 (79) | 1302 (77) | 1020 (76) | 589 (78) | 368 (78) | 4964 (78) |
CKD aetiology, n (%) | |||||||
Hypertension/vascular | 167 (14) | 189 (14) | 249 (15) | 189 (14) | 92 (12) | 64 (14) | 886 (14) |
Glomerulonephritis | 196 (16) | 234 (17) | 263 (16) | 229 (17) | 146 (19) | 95 (20) | 1068 (17) |
Diabetes | 208 (17) | 208 (15) | 268 (16) | 153 (11) | 54 (7) | 27 (6) | 891 (14) |
Tubulo-interstitial | 178 (15) | 187 (14) | 220 (13) | 171 (13) | 120 (16) | 80 (17) | 876 (14) |
Polycystic kidney disease | 60 (5) | 73 (5) | 100 (6) | 83 (6) | 67 (9) | 43 (9) | 383 (6) |
Miscellaneous | 37 (3) | 40 (3) | 78 (5) | 61 (5) | 34 (5) | 20 (4) | 250 (4) |
Unknown | 257 (21) | 309 (23) | 392 (23) | 348 (26) | 190 (25) | 116 (25) | 1496 (23) |
Missing | 114 (9) | 125 (9) | 120 (7) | 109 (8) | 51 (7) | 27 (6) | 519 (8) |
Healthcare resource utilisation
Healthcare costs
Baseline iPTH*, pg/mL | Total | ||||||
---|---|---|---|---|---|---|---|
< 75 | ≥ 75 – < 150 | ≥ 150 – ≤ 300 | > 300 – ≤ 600 | > 600 | > 800 | ||
N patients | 1054 | 1145 | 1394 | 1140 | 653 | 405 | 5386 |
Total cost per month (including patients with zero costs), 2006 € | |||||||
Mean | 60.52 | 67.01 | 73.47 | 82.46 | 109.97 | 114.12 | 75.89 |
SD | 196.55 | 300.32 | 264.06 | 156.54 | 168.81 | 192.30 | 231.52 |
Median | 16.15 | 22.34 | 26.66 | 41.68 | 57.69 | 56.57 | 28.61 |
Q1, Q3 | 5.01, 52.09 | 7.85, 69.08 | 9.18, 79.33 | 12.05, 101.16 | 14.88, 131.21 | 13.37, 132.83 | 8.55, 83.69 |
Min, Max | 0.00, 3895.54 | 0.00, 9533.54 | 0.00, 7518.35 | 0.00, 3790.69 | 0.00, 2031.16 | 0.00, 2031.16 | 0.00, 9533.54 |
Patients with total cost per month > €0, n (%) | 937 (89) | 1052 (92) | 1284 (92) | 1060 (93) | 605 (93) | 372 (92) | 4938 (92) |
Cost of hospitalisations per month (including patients with zero costs), 2006 € | |||||||
Mean | 23.40 | 23.21 | 21.50 | 17.87 | 25.51 | 29.49 | 21.95 |
SD | 188.45 | 295.38 | 254.07 | 137.19 | 129.88 | 152.03 | 219.56 |
Median | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
Q1, Q3 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 |
Min, Max | 0.00, 3879.20 | 0.00, 9533.54 | 0.00, 7501.80 | 0.00, 3790.69 | 0.00, 1879.98 | 0.00, 1879.98 | 0.00, 9533.54 |
Patients with hospitalisation cost per month > €0, n (%) | 40 (4) | 50 (4) | 51 (4) | 63 (6) | 50 (8) | 34 (8) | 254 (5) |
Cost of medications per month (including patients with zero costs), 2006 € | |||||||
Mean | 37.12 | 43.81 | 51.97 | 64.59 | 84.46 | 84.63 | 53.94 |
SD | 54.32 | 56.55 | 70.41 | 76.68 | 103.14 | 107.58 | 72.70 |
Median | 14.98 | 21.01 | 24.88 | 39.44 | 52.30 | 49.35 | 26.02 |
Q1, Q3 | 4.71, 48.12 | 7.34, 60.07 | 8.74, 71.46 | 11.20, 92.55 | 13.01, 112.43 | 11.38, 111.02 | 8.04, 74.56 |
Min, Max | 0.00, 445.09 | 0.00, 418.67 | 0.00, 709.97 | 0.00, 698.08 | 0.00, 676.07 | 0.00, 676.07 | 0.00, 709.97 |
Patients with medication cost per month > €0, n (%) | 933 (89) | 1049 (92) | 1281 (92) | 1054 (92) | 603 (92) | 372 (92) | 4920 (91) |
Baseline total calcium*, mmol/mL | Total | ||||
---|---|---|---|---|---|
< 2.10 | ≥ 2.10 – ≤ 2.37 | > 2.37 | Missing | ||
N patients | 833 | 2980 | 1405 | 168 | 5386 |
Total cost per month (including patients with zero costs), 2006 € | |||||
Mean | 70.52 | 72.57 | 86.09 | 75.96 | 75.89 |
SD | 308.29 | 233.85 | 171.97 | 171.79 | 231.52 |
Median | 23.02 | 25.83 | 37.39 | 36.51 | 28.61 |
Q1, Q3 | 7.34, 68.65 | 8.32, 79.72 | 9.88, 104.82 | 9.87, 78.81 | 8.55, 83.69 |
Min, Max | 0.00, 7518.35 | 0.00, 9533.54 | 0.00, 3790.69 | 0.00, 1766.00 | 0.00, 9533.54 |
Patients with total cost per month > €0, n (%) | 759 (91) | 2742 (92) | 1274 (91) | 163 (97) | 4938 (92) |
Cost of hospitalisations per month (including patients with zero costs), 2006 € | |||||
Mean | 26.33 | 21.08 | 19.91 | 32.71 | 21.95 |
SD | 303.23 | 221.58 | 150.74 | 171.24 | 219.56 |
Median | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
Q1, Q3 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 |
Min, Max | 0.00, 7501.80 | 0.00, 9533.54 | 0.00, 3790.69 | 0.00, 1766.00 | 0.00, 9533.54 |
Patients with hospitalisation cost per month > €0, n (%) | 33 (4) | 136 (5) | 74 (5) | 11 (7) | 254 (5) |
Cost of medications per month (including patients with zero costs), 2006 € | |||||
Mean | 44.19 | 51.49 | 66.18 | 43.25 | 53.94 |
SD | 61.73 | 70.83 | 83.31 | 40.75 | 72.70 |
Median | 20.08 | 23.49 | 35.89 | 32.38 | 26.02 |
Q1, Q3 | 6.32, 59.11 | 7.89, 70.28 | 9.26, 91.74 | 8.51, 64.91 | 8.04, 74.56 |
Min, Max | 0.00, 549.78 | 0.00, 709.97 | 0.00, 589.91 | 0.00, 159.19 | 0.00, 709.97 |
Patients with medication cost per month > €0, n (%) | 754 (91) | 2737 (92) | 1269 (90) | 160 (95) | 4920 (91) |
Baseline phosphate*, mmol/mL | Total | ||||
---|---|---|---|---|---|
< 1.13 | ≥ 1.13 – ≤ 1.78 | > 1.78 | Missing | ||
N patients | 827 | 3104 | 1208 | 247 | 5386 |
Total cost per month (including patients with zero costs), 2006 € | |||||
Mean | 62.02 | 75.27 | 88.88 | 66.60 | 75.89 |
SD | 176.01 | 273.40 | 145.08 | 147.07 | 231.52 |
Median | 15.24 | 26.66 | 46.00 | 28.57 | 28.61 |
Q1, Q3 | 4.48, 54.32 | 8.51, 82.41 | 14.49, 107.77 | 10.65, 72.60 | 8.55, 83.69 |
Min, Max | 0.00, 3790.69 | 0.00, 9533.54 | 0.00, 2031.16 | 0.00, 1766.00 | 0.00, 9533.54 |
Patients with cost per month > €0, n (%) | 732 (89) | 2856 (92) | 1116 (92) | 234 (95) | 4938 (92) |
Cost of hospitalisations per month (including patients with zero costs), 2006 € | |||||
Mean | 24.81 | 22.53 | 17.87 | 25.05 | 21.95 |
SD | 165.02 | 264.57 | 111.07 | 142.43 | 219.56 |
Median | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 |
Q1, Q3 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 | 0.00, 0.00 |
Min, Max | 0.00, 3790.69 | 0.00, 9533.54 | 0.00, 1879.98 | 0.00, 1766.00 | 0.00, 9533.54 |
Patients with hospitalisation cost per month > €0, n (%) | 50 (6) | 130 (4) | 60 (5) | 14 (6) | 254 (5) |
Cost of medications per month (including patients with zero costs), 2006 € | |||||
Mean | 37.21 | 52.74 | 71.01 | 41.55 | 53.94 |
SD | 60.95 | 69.83 | 87.04 | 44.81 | 72.70 |
Median | 13.45 | 24.96 | 41.28 | 27.11 | 26.02 |
Q1, Q3 | 3.89, 45.32 | 8.12, 74.40 | 13.37, 95.17 | 10.57, 62.62 | 8.04, 74.56 |
Min, Max | 0.00, 549.78 | 0.00, 709.97 | 0.00, 676.07 | 0.00, 365.41 | 0.00, 709.97 |
Patients with medication cost per month > €0, n (%) | 727 (88) | 2848 (92) | 1112 (92) | 233 (94) | 4920 (91) |
Baseline level* | n | Relative cost coefficient (95% CI) | |
---|---|---|---|
Univariate analysis†
| Multivariate analysis‡
| ||
iPTH, pg/mL | |||
< 75 | 1054 | 1.01 (0.92, 1.12) | 0.98 (0.89, 1.09) |
≥ 75 – < 150 | 1145 | 0.98 (0.89, 1.08) | 1.00 (0.91, 1.10) |
≥ 150 – ≤ 300 (reference) | 1394 | 1.00 | 1.00 |
> 300 – ≤ 600 | 1140 | 1.11 (1.01, 1.22) | 1.11 (1.01, 1.22) |
> 600 | 653 | 1.53 (1.36, 1.71) | 1.41 (1.25, 1.59) |
Total calcium (mmol/L) | |||
< 2.10 mmol/L | 833 | 1.06 (0.97, 1.17) | 1.01 (0.92, 1.11) |
≥ 2.10 – ≤ 2.37 mmol/L (reference) | 2980 | 1.00 | 1.00 |
> 2.37 mmol/L | 1405 | 1.14 (1.06, 1.24) | 1.08 (1.00, 1.17) |
Missing | 168 | 1.26 (1.03, 1.54) | 1.54 (1.18, 2.00) |
Phosphate (mmol/L) | |||
< 1.13 mmol/L | 827 | 0.75 (0.68, 0.82) | 0.75 (0.68, 0.82) |
≥ 1.13 – ≤ 1.78 mmol/L (reference) | 3104 | 1.00 | 1.00 |
> 1.78 mmol/L | 1208 | 1.39 (1.28, 1.51) | 1.38 (1.27, 1.50) |
Missing | 247 | 0.94 (0.79, 1.12) | 0.70 (0.55, 0.88) |
Sensitivity analyses
Baseline level* | Follow-up duration 3 months (N=5009) | Follow-up duration 6 months (N=4370) | Total healthcare cost > €0 (N=4938) | |||
---|---|---|---|---|---|---|
n | Relative Cost†(95% CI) | n | Relative Cost†(95% CI) | n | Relative Cost†‡(95% CI) | |
iPTH, pg/mL | ||||||
< 75 | 965 | 0.90 (0.81, 1.00) | 837 | 0.81 (0.72, 0.90) | 937 | 1.00 (0.91, 1.10) |
≥ 75 – < 150 | 1064 | 1.02 (0.92, 1.13) | 928 | 1.00 (0.90, 1.11) | 1052 | 0.99 (0.91, 1.09) |
≥ 150 – ≤ 300 (reference) | 1295 | 1.00 | 1124 | 1.00 | 1284 | 1.00 |
> 300 – ≤ 600 | 1068 | 1.14 (1.03, 1.27) | 926 | 1.05 (0.95, 1.17) | 1060 | 1.10 (1.00, 1.20) |
> 600 | 617 | 1.50 (1.32, 1.70) | 555 | 1.37 (1.20, 1.56) | 605 | 1.40 (1.25, 1.57) |
Total calcium (mmol/L) | ||||||
< 2.10 mmol/L | 766 | 0.96 (0.87, 1.07) | 631 | 0.95 (0.85, 1.06) | 759 | 1.01 (0.92, 1.11) |
≥ 2.10 – ≤ 2.37 mmol/L (reference) | 2773 | 1.00 | 2397 | 1.00 | 2742 | 1.00 |
> 2.37 mmol/L | 1311 | 1.03 (0.94, 1.12) | 1195 | 1.00 (0.92, 1.10) | 1274 | 1.10 (1.02, 1.19) |
Missing | 159 | 1.41 (1.02, 1.96) | 147 | 1.14 (0.82, 1.58) | 163 | 1.52 (1.18, 1.95) |
Phosphate (mmol/L) | ||||||
< 1.13 mmol/L | 764 | 0.77 (0.70, 0.86) | 673 | 0.80 (0.71, 0.89) | 732 | 0.78 (0.71, 0.85) |
≥ 1.13 – ≤ 1.78 mmol/L (reference) | 2889 | 1.00 | 2526 | 1.00 | 2856 | 1.00 |
> 1.78 mmol/L | 1131 | 1.37 (1.25, 1.50) | 960 | 1.44 (1.31, 1.58) | 1116 | 1.38 (1.27, 1.50) |
Missing | 225 | 0.87 (0.64, 1.16) | 211 | 0.85 (0.63, 1.15) | 234 | 0.73 (0.59, 0.92) |