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Chronic kidney disease, health-related quality of life and their associated economic burden among a nationally representative sample of community dwelling adults in England

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  • Nga T Q Nguyen
  • Paul Cockwell
  • Alexander P Maxwell
  • Matthew Griffin
  • Timothy O’Brien
  • Ciaran O’Neill

Abstract

Chronic kidney disease (CKD) affects up to 15% of the adult population and is strongly associated with other non-communicable chronic diseases including diabetes. However, there is limited information on a population basis of the relationship between CKD and health-related quality of life (HRQoL) and the consequent economic cost. We investigated this relationship in a representative sample in England using the 2010 Health Survey for England. Multivariable Tobit models were used to examine the relationship between HRQoL and CKD severity. HRQoL was converted to quality adjusted life year (QALY) measures by combining decrements in quality of life with reductions in life expectancy associated with increased disease severity. QALYs were adjusted for discounting and monetised using the UK threshold for reimbursement of £30,000. The QALYs were then used in conjunction with forecasted prevalence to estimate the HRQoL burden associated with CKD among individuals with diabetes up to 2025. Individuals with more severe CKD had lower HRQoL compared to those with better kidney function. Compared to those with normal/low normal kidney function and stage 1 CKD, those with stage 2, stage 3 with albuminuria and stage 4/5 CKD experienced a decrement of 0.11, 0.18 and 0.28 in their utility index, respectively. Applying the UK reimbursement threshold for a QALY, the monetised lifetime burden of reduced HRQoL due to stage 2, stage 3 with albuminuria and stage 4/5 CKD were £103,734; £83,399; £125,335 in males and £143,582; £70,288; £203,804 in females, respectively. Utilizing the predicted prevalence of CKD among individuals with diabetes mellitus, the economic burden of CKD per million of individuals with diabetes is forecasted at approximately £11.4 billion in 2025. In conclusion, CKD has a strong adverse impact on HRQoL in multiple domains. The estimated economic burden of CKD among individuals with diabetes mellitus in the UK is projected to rise markedly over time.

Suggested Citation

  • Nga T Q Nguyen & Paul Cockwell & Alexander P Maxwell & Matthew Griffin & Timothy O’Brien & Ciaran O’Neill, 2018. "Chronic kidney disease, health-related quality of life and their associated economic burden among a nationally representative sample of community dwelling adults in England," PLOS ONE, Public Library of Science, vol. 13(11), pages 1-12, November.
    • Handle: RePEc:plo:pone00:0207960
    DOI: 10.1371/journal.pone.0207960
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    1. Mark D Jesky & Mary Dutton & Indranil Dasgupta & Punit Yadav & Khai Ping Ng & Anthony Fenton & Derek Kyte & Charles J Ferro & Melanie Calvert & Paul Cockwell & Stephanie J Stringer, 2016. "Health-Related Quality of Life Impacts Mortality but Not Progression to End-Stage Renal Disease in Pre-Dialysis Chronic Kidney Disease: A Prospective Observational Study," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-18, November.
    2. Richard Williams, 2011. "Using the Margins Command to Estimate and Interpret Adjusted Predictions and Marginal Effects," CHI11 Stata Conference 9, Stata Users Group.
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    1. Ruwan Jayathilaka & Sheron Joachim & Venuri Mallikarachchi & Nishali Perera & Dhanushika Ranawaka, 2020. "Chronic diseases: An added burden to income and expenses of chronically-ill people in Sri Lanka," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-25, October.
    2. Ruwan Jayathilaka & Sheron Joachim & Venuri Mallikarachchi & Nishali Perera & Dhanushika Ranawaka, 2020. "Do chronic illnesses and poverty go hand in hand?," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-19, October.
    3. Jianjian Liu & Wei Yu & Jiayi Zhou & Yifan Yang & Shuoni Chen & Shaotang Wu, 2020. "Relationship between the Number of Noncommunicable Diseases and Health-Related Quality of Life in Chinese Older Adults: A Cross-Sectional Survey," IJERPH, MDPI, vol. 17(14), pages 1-11, July.

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