Economic Analysis of a Ketoanalogue-Supplemented Very Low-Protein Diet in Patients With Chronic Kidney Disease in Taiwan and Thailand.
Study Goal
The researchers aimed to compare the cost-effectiveness and health outcomes of a ketoanalogue-supplemented vegetarian very low-protein diet (sVLPD) versus a conventional low-protein diet (LPD) in patients with chronic kidney disease (CKD) stages 4-5.
Results Summary
The sVLPD increased survival and quality-adjusted life years (QALYs) at a lower cost than the LPD in both Taiwan and Thailand, demonstrating its cost-effectiveness and clinical benefits for delaying dialysis initiation.
Population
Patients with chronic kidney disease (CKD) stages 4-5 in Taiwan and Thailand.
Effective Dosage
sVLPD (0.3-0.4 g/kg-day, vegetarian diet) supplemented with ketoanalogues (1 tablet/5 kg-day); LPD (0.6 g/kg-day, mixed proteins).
Duration
Not specified in the abstract.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
ketoanalogue-supplemented very low-protein diet (sVLPD) | decrease | dialysis initiation | patients with chronic kidney disease (CKD) | - | delays | #1 |
ketoanalogue-supplemented very low-protein diet (sVLPD) | increase | survival | patients with CKD stage 4-5 | - | increased | #2 |
ketoanalogue-supplemented very low-protein diet (sVLPD) | increase | quality-adjusted life years (QALYs) | patients with CKD stage 4-5 | - | increased | #3 |
ketoanalogue-supplemented very low-protein diet (sVLPD) | decrease | total cost of care | patients with CKD stage 4-5 in Taiwan | -1,165,654.10 NTD (-35,063.17 EUR) | lower cost | #4 |
ketoanalogue-supplemented very low-protein diet (sVLPD) | decrease | total cost of care | patients with CKD stage 4-5 in Thailand | -79,711.86 THB (-2,321.66 EUR) | lower cost | #5 |
ketoanalogue-supplemented vegetarian sVLPD | increase | QALYs | patients with predialysis CKD in Taiwan and Thailand | - | increased | #6 |
ketoanalogue-supplemented vegetarian sVLPD | decrease | lifetime care costs | patients with predialysis CKD in Taiwan and Thailand | - | lowered | #7 |
ketoanalogue-supplemented vegetarian sVLPDs | decrease | CKD progression | - | - | prevent | #8 |
ketoanalogue-supplemented vegetarian sVLPDs | decrease | dialysis | - | - | postpone | #9 |
OBJECTIVE: A vegetarian very low-protein diet (VLPD) supplemented with ketoanalogues of essential amino acids Ketoanalogue-supplemented very low-protein diet (sVLPD) delays dialysis initiation in patients with chronic kidney disease (CKD). In this cost-effectiveness analysis, we compare an sVLPD with a conventional low-protein diet (LPD) in patients with CKD stage 4-5 using data from Taiwan and Thailand. DESIGN AND METHODS: A Markov model simulated health outcomes and care costs in patients receiving an sVLPD (0.3-0.4 g/kg-day, vegetarian diet) supplemented with ketoanalogues (1 tablet/5 kg-day) or an LPD (0.6 g/kg-day, mixed proteins). Health state transition probability and resource cost inputs were based on published literature and local sources, respectively. RESULTS: An sVLPD increased survival and quality-adjusted life years (QALYs) at a lower cost than an LPD. Total cost of care in Taiwan was 2,262,592.30 New Taiwan dollars (NTD) (68,059.35 EUR) with an LPD and 1,096,938.20 NTD (32,996.18 EUR) with an sVLPD (difference -1,165,654.10 NTD; -35,063.17 EUR). Total cost of care in Thailand was 500,731.09 Thai baht (THB) (14,584.12 EUR) with an LPD and 421,019.22 THB (12,262.46 EUR) with an sVLPD (difference -79,711.86 THB; -2,321.66 EUR). CONCLUSION: A ketoanalogue-supplemented vegetarian sVLPD increased QALYs and lowered lifetime care costs versus an LPD in patients with predialysis CKD in Taiwan and Thailand. These data, together with the new KDOQI Guidelines for nutrition in CKD, support dietary intervention using ketoanalogue-supplemented vegetarian sVLPDs to prevent CKD progression and postpone dialysis as a cost-effective approach, with beneficial effects for patients and health care providers.