| Uremia (end-stage renal disease): how cost-effective are preventive strategies? | |
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MedLine Citation:
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PMID: 20797562 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Many strategies have been shown to be cost-effective for prevention of end-stage renal disease (ESRD), most often by Markov modeling using assumptions based on randomized clinical trails and observational studies. Targeted screening for proteinuria in diabetics and in hypertensive patients is cost-effective for prevention of ESRD, but such screening is not cost-effective when applied to the general population. Screening for chronic kidney disease based on estimated glomerular filtration rate alone is not recommended. Perhaps, treatment of all newly diagnosed type 2 diabetics with an inhibitor of angiotensin-II without screening for proteinuria will also prevent or delay ESRD in a cost-effective manner. Intensive interventions and the use of angiotensin-II inhibition in incipient and overt nephropathy in type 1 and type 2 diabetes is also cost-effective in preventing ESRD. Rigorous control of blood pressure to desired targets also lowers the risks of ESRD in both diabetic and nondiabetic nephropathies, most likely in a cost-effective manner. Newer strategies involving statins and new combinations of agents are emerging but have not yet been tested for their cost-effectiveness in preventing ESRD cost-effectiveness. |
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Authors:
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Richard J Glassock |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation Volume: 20 ISSN: 1532-8503 ISO Abbreviation: J Ren Nutr Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-27 Completed Date: 2011-01-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9112938 Medline TA: J Ren Nutr Country: United States |
Other Details:
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Languages: eng Pagination: S131-4 Citation Subset: IM |
Copyright Information:
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Copyright 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medicine, The David Geffen School of Medicine at UCLA, Los Angeles, California, USA. glassock@cox.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin II
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antagonists & inhibitors Antihypertensive Agents / therapeutic use Cost-Benefit Analysis Diabetes Mellitus, Type 1 / complications, drug therapy Diabetes Mellitus, Type 2 / complications, drug therapy Diabetic Nephropathies / drug therapy Glomerular Filtration Rate Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Kidney Failure, Chronic / economics*, etiology, prevention & control* Mass Screening / economics Proteinuria / diagnosis |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 11128-99-7/Angiotensin II |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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