An Economic Assessment Model of Rural and Remote Satellite Hemodialysis Units

<div><p>Background</p><p>Kidney Failure is epidemic in many remote communities in Canada. In-centre hemodialysis is provided within these settings in satellite hemodialysis units. The key cost drivers of this program have not been fully described. Such information is important in informing the design of programs aimed at optimizing efficiency in providing dialysis and preventative chronic kidney disease care in remote communities.</p><p>Design, Setting, Participants, and Measurements</p><p>We constructed a cost model based on data derived from 16 of Manitoba, Canada’s remote satellite units. We included all costs for operation of the unit, transportation, treatment, and capital costs. All costs were presented in 2013 Canadian dollars.</p><p>Results</p><p>The annual per-patient cost of providing hemodialysis in the satellite units ranged from $80,372 to$215,918 per patient, per year. The median per patient, per year cost was $99,888 (IQR$89,057—$122,640). Primary cost drivers were capital costs related to construction, human resource expenses, and expenses for return to tertiary care centres for health care. Costs related to transport considerably increased estimates in units that required plane or helicopter transfers.</p><p>Conclusions</p><p>Satellite hemodialysis units in remote areas are more expensive on a per-patient basis than hospital hemodialysis and satellite hemodialysis available in urban areas. In some rural, remote locations, better value for money may reside in local surveillance and prevention programs in addition support for home dialysis therapies over construction of new satellite hemodialysis units.</p></div

Cost Model–Average Annual Per-Patient Cost in Communities Accessible by Air.

<p>Cost Model–Average Annual Per-Patient Cost in Communities Accessible by Air.</p

Sensitivity Analysis of Annual, Per-Patient Costs by Monthly Operating Efficiency.

<p>Gray lines represent road accessible units and black lines represent primarily air accessible units.</p

Characteristics of Local Centre Dialysis Units.

<p>Characteristics of Local Centre Dialysis Units.</p

Component Costs as a Percentage of Total Annual, Per-Patient Costs

<p>Component Costs as a Percentage of Total Annual, Per-Patient Costs</p

sj-docx-1-cjk-10.1177_20543581231162218 – Supplemental material for Magnitude of the Potential Screening Gap for Fabry Disease in Manitoba: A Population-Based Retrospective Cohort Study

Supplemental material, sj-docx-1-cjk-10.1177_20543581231162218 for Magnitude of the Potential Screening Gap for Fabry Disease in Manitoba: A Population-Based Retrospective Cohort Study by Reid H. Whitlock, Mohammad Nour-Mohammadi, Sarah Curtis, Paul Komenda, Clara Bohm, David Collister, Navdeep Tangri and Claudio Rigatto in Canadian Journal of Kidney Health and Disease</p

Global trends in chronic kidney disease-related mortality: a systematic review protocol

Introduction: In recent decades, all-cause mortality has increased among individuals with chronic kidney disease (CKD), influenced by factors such as aetiology, standards of care and access to kidney replacement therapies (dialysis and transplantation). The recent COVID-19 pandemic also affected mortality over the past few years. Here, we outline the protocol for a systematic review to investigate global temporal trends in all-cause mortality among patients with CKD at any stage from 1990 to current. We also aim to assess temporal trends in the mortality rate associated with the COVID-19 pandemic. Methods and analysis: We will conduct a systematic review of studies reporting mortality for patients with CKD following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will search electronic databases, national and multiregional kidney registries and grey literature to identify observational studies that reported on mortality associated with any cause for patients with CKD of all ages with any stage of the disease. We will collect data between April and August 2023 to include all studies published from 1990 to August 2023. There will be no language restriction, and clinical trials will be excluded. Primary outcome will be temporal trends in CKD-related mortality. Secondary outcomes include assessing mortality differences before and during the COVID-19 pandemic, exploring causes of death and examining trends across CKD stages, country classifications, income levels and demographics. Ethics and dissemination: A systematic review will analyse existing data from previously published studies and have no direct involvement with patient data. Thus, ethical approval is not required. Our findings will be published in an open-access peer-reviewed journal and presented at scientific conferences. Prospero registration number: CRD42023416084.</p

sj-tif-1-cjk-10.1177_20543581241238808 – Supplemental material for Pathways for Diagnosing and Treating CKD-Associated Pruritus: A Narrative Review

Supplemental material, sj-tif-1-cjk-10.1177_20543581241238808 for Pathways for Diagnosing and Treating CKD-Associated Pruritus: A Narrative Review by Claudio Rigatto, David Collister, Alexandre Granger-Vallée, Louis Girard, Jay Hingwala, Angelo Karaboyas, Adeera Levin, Philip McFarlane, Ron Pisoni, Bhanu Prasad, Normand Proulx, Daniel Schwartz, Manish Sood, Rita Suri and Karthik Tennankore in Canadian Journal of Kidney Health and Disease</p