在美国等待移植的肾移植受者中新发高脂血症的发病率和费用

R. Woodward, T. Page, A. Menclova, M. Schnitzler, D. Brennan
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引用次数: 0

摘要

背景:高脂血症增加死亡率,在肾脏疾病中很常见。等待移植和移植后患者的新发高脂血症(NOHL)可能影响肾脏疾病患者的成本和移植生存。方法:使用美国肾脏数据系统,我们比较了移植前第二年和第一年的等待名单患者和移植后第一年和第二年的移植患者与医疗保险相关的费用。我们还研究了对NOHL移植物存活的影响。结果:新发高脂血症在移植前发生的代价特别高。与无高脂血症患者相比,早发性高脂血症患者在移植前两年多花费15,228美元,移植后两年多花费14,673美元。正如先前的研究所发现的那样,没有任何NOHL的患者的移植物存活率最差。结论:尽管NOHL与移植前和移植后费用增加有关,但在移植前和移植后第二年诊断为NOHL的患者在移植后2年的移植存活率高于未诊断为NOHL的患者。先前的研究将这种关系归因于炎症和营养不良,这导致胆固醇水平降低,结果更糟。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Incidence and Cost of New Onset Hyperlipidemia Claims Among US Wait-Listed and Transplanted Renal Allograft Recipients~!2009-07-15~!2009-11-06~!2010-03-22~!
Background: Hyperlipidemia increases mortality and is common with kidney-disease. New-onset hyperlipidemia (NOHL) among patients wait-listed and after transplantation may impact costs and graft-survival of patients with kidney disease. Methods: Using the United States Renal Data System, we compared the costs to Medicare associated with or without NOHL in wait-listed patients in the second and first year pre-transplant and transplanted patients in the first and second year post-transplant. We also examined the impact on graft-survival of NOHL. Results: New onset hyperlipidemia was especially expensive when it occurred well before transplantation. When compared with individuals with no hyperlipidemia, patients with early onset hyperlipidemia cost an extra $15,228 in the two years before transplantation and an extra $14,673 in the two years following transplantation. As has been found in prior studies, patients without any NOHL had the worst graft survival rates. Conclusions: Although NOHL was associated with increased pre- and post-transplant costs, patients diagnosed with NOHL between the second year before and second year after transplantation experienced higher graft-survival rates than those without NOHL by 2-years post-transplantation. Prior studies attribute this relationship to inflammation and malnutrition, which result in lower cholesterol levels and worse outcomes.
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