Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 May 31;14(5):e0217487.
doi: 10.1371/journal.pone.0217487. eCollection 2019.

Lifetime benefits of early detection and treatment of diabetic kidney disease

Julia Thornton Snider  1 , Jeffrey Sullivan  1 , Emma van Eijndhoven  1 , Michael K Hansen  2 , Nobel Bellosillo  3 , Cheryl Neslusan  4 , Ellen O'Brien  4 , Ralph Riley  4 , Seth Seabury  1 , Bertram L Kasiske  5
Affiliations

Lifetime benefits of early detection and treatment of diabetic kidney disease

Julia Thornton Snider et al. PLoS One. .

Abstract

Objectives: Diabetic kidney disease (DKD) is a frequent complication of diabetes with potentially devastating consequences that may be prevented or delayed. This study aimed to estimate the health and economic benefit of earlier diagnosis and treatment of DKD.

Methods: Life expectancy and medical spending for people with diabetes were modeled using The Health Economics Medical Innovation Simulation (THEMIS). THEMIS uses data from the Health and Retirement Study to model cohorts of individuals over age 50 to project population-level lifetime health and economic outcomes. DKD status was imputed based on diagnoses and laboratory values in the National Health and Nutrition Examination Survey. We simulated the implementation of a new biomarker identifying people with diabetes at an elevated risk of DKD and DKD patients at risk of rapid progression.

Results: Compared to baseline, the prevalence of DKD declined 5.1% with a novel prognostic biomarker test, while the prevalence of diabetes with stage 5 chronic kidney disease declined 3.0%. Consequently, people with diabetes gained 0.2 years in life expectancy, while per-capita annual medical spending fell by 0.3%. The estimated cost was $12,796 per life-year gained and $25,842 per quality-adjusted life-year.

Conclusions: A biomarker test that allows earlier treatment reduces DKD prevalence and slows DKD progression, thereby increasing life expectancy among people with diabetes while raising healthcare spending by less than one percent.

PubMed Disclaimer

Conflict of interest statement

Dr. Snider, Mr. Sullivan, and Ms. van Eijndhoven are employees of PHE, which provides consulting services to life science firms. Dr. Snider holds equity in PHE. Dr. Kasiske and Dr. Seabury are consultants for PHE. Mr. Riley, Dr. Hansen, Dr. Neslusan, Dr. O’Brien, and Dr. Bellosillo are employees of Janssen, which provided financial support to PHE for this study. Janssen's website can be found here: https://www.janssen.com/us/. Janssen played a role in the study design, decision to publish, and review of the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. DKD and diabetes with stage 5 CKD prevalence among US population aged ≥ 51.
Notes: DKD indicates diabetic kidney disease; CKD, chronic kidney disease.
Fig 2
Fig 2. Life expectancy from age 51, by group.
Notes: Reported life expectancies are the average values for a group across all years of the simulation (2010–2050). DKD indicates diabetic kidney disease; CKD, chronic kidney disease.
Fig 3
Fig 3. Annual healthcare expenditure per person, by group.
Notes: Reported healthcare expenditures per person are the average values for a group across all years of the simulation (2010–2050). DKD indicates diabetic kidney disease; CKD, chronic kidney disease.
Fig 4
Fig 4. Total annual government health versus non-health spending on people with diabetes.
Notes: Reported annual healthcare expenditures are the average values across all years of the simulation (2010–2050). DKD indicates diabetic kidney disease; CKD, chronic kidney disease.
See this image and copyright information in PMC

References

    1. Kidney Disease Improving Global Outcomes Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney International Supplements. 2013;3(1):1–150. - PMC - PubMed
    1. Atkins RC. The epidemiology of chronic kidney disease. Kidney International. 2005;67(Supplement 94):S14–S8. - PubMed
    1. Centers for Disease Control and Prevention. National diabetes statistics report, 2017 Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2017.
    1. World Health Organization. Global report on diabetes Geneva, CH: World Health Organization; 2016.
    1. Murphy D, McCulloch CE, Lin F, Banerjee T, Bragg-Gresham JL, Eberhardt MS, et al. Trends in prevalence of chronic kidney disease in the United States. Annals of Internal Medicine. 2016;165(7):473–81. 10.7326/M16-0273 - DOI - PMC - PubMed

Publication types

MeSH terms