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dc.contributor.authorDesai, Amar A.
dc.contributor.authorBaras, Jacqueline
dc.contributor.authorBerk, Benjamin B.
dc.contributor.authorNakajima, Aya
dc.contributor.authorGarber, Alan M
dc.contributor.authorOwens, Douglas
dc.contributor.authorChertow, Glenn M.
dc.date.accessioned2014-01-23T19:15:45Z
dc.date.issued2008
dc.identifierQuick submit: 2013-12-20T20:18:30-05:00
dc.identifier.citationDesai, Amar A., Jacqueline Baras, Benjamin B. Berk, Aya Nakajima, Alan M. Garber, Douglas Owens, and Glenn M. Chertow. 2008. Management of acute kidney injury in the intensive care unit. Archives of Internal Medicine 168, 16:1761-1767.en_US
dc.identifier.issn0003-9926en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:11577347
dc.description.abstractBackground Although evidence suggests that a higher hemodialysis dose and/or frequency may be associated with improved outcomes, the cost-effectiveness of a daily hemodialysis strategy for critically ill patients with acute kidney injury (AKI) is unknown. Methods We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of daily hemodialysis, compared with alternate-day hemodialysis, for patients with AKI in the intensive care unit (ICU). We employed a societal perspective with a lifetime analytic time horizon. We modeled the efficacy of daily hemodialysis as a reduction in the relative risk of death on the basis of data reported in the 2004 clinical trial published by Schiffl et al. We performed 1- and 2-way sensitivity analyses across cost, efficacy, and utility input variables. The main outcome measure was cost per quality-adjusted life-year (QALY). Results In the base case for a 60-year-old man, daily hemodialysis was projected to add 2.14 QALYs and $10 924 in cost. We found that the cost-effectiveness of daily hemodialysis compared with alternate-day hemodialysis was $5084 per QALY gained. The incremental cost-effectiveness ratio became less favorable (>$50 000 per QALY gained) when the maintenance hemodialysis rate of the daily hemodialysis group was varied to more than 27% and when the difference in 14-day postdischarge mortality between the alternatives was varied to less than 0.5%. Conclusion Daily hemodialysis is a cost-effective strategy compared with alternate-day hemodialysis for patients with severe AKI in the ICU.en_US
dc.language.isoen_USen_US
dc.publisherAmerican Medical Associationen_US
dc.relation.isversionofdoi:10.1001/archinte.168.16.1761en_US
dc.relation.isversionofhttp://archinte.jamanetwork.com/article.aspx?articleid=414444en_US
dash.licenseMETA_ONLY
dc.titleManagement of acute kidney injury in the intensive care unit: a cost-effectiveness analysis of daily vs alternative-day hemodialysisen_US
dc.typeJournal Articleen_US
dc.date.updated2013-12-21T01:19:50Z
dc.description.versionVersion of Recorden_US
dc.rights.holderDesai AA; Baras J; Berk BB; Nakajima A; Garber AM; Owens D; Chertow GM
dc.relation.journalArchives of Internal Medicineen_US
dash.depositing.authorGarber, Alan M
dash.embargo.until10000-01-01
dc.identifier.doi10.1001/archinte.168.16.1761*
dash.contributor.affiliatedGarber, Alan


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