Health Care Costs Associated with AKI.

Background And Objectives: An understanding of the health care resource use associated with AKI is needed to frame the investment and cost-effectiveness of strategies to prevent AKI and promote kidney recovery.

Design, Setting, Participants, & Measurements: We assembled population-based cohort of adults hospitalized in Alberta between November of 2002 and March of 2009 without ESRD or an eGFR<15 ml/min per 1.73 m.

Economic evaluation of dialysis therapies.

The prevalence of chronic kidney disease and end-stage renal disease requiring dialysis therapy continues to increase worldwide, and despite technological advances, treatment remains resource intensive. Thus, the increasing burden of dialysis therapy on finite health-care budgets is an important consideration. The principles of allocative efficiency and the concept of 'opportunity cost' can be used to assess whether dialysis is economically justified; if dialysis is to be provided, cost-minimization and cost-utility analyses can be used to identify the most efficient dialysis modality.

The use of high-dose hydroxocobalamin for vasoplegic syndrome.

We describe a case of hypotension on cardiopulmonary bypass for coronary artery bypass grafting, double valve repairs, and patent foramen ovale closure. The patient experienced vasoplegic syndrome while on cardiopulmonary bypass. He was treated with high-dose hydroxocobalamin (vitamin B12).

Health care costs in people with diabetes and their association with glycemic control and kidney function.

Objective: To determine the association between laboratory-derived measures of glycemic control (HbA1c) and the presence of renal complications (measured by proteinuria and estimated glomerular filtration rate [eGFR]) with the 5-year costs of caring for people with diabetes.

Research Design And Methods: We estimated the cumulative 5-year cost of caring for people with diabetes using a province-wide cohort of adults with diabetes as of 1 May 2004. Costs included physician visits, hospitalizations, ambulatory care (emergency room visits, day surgery, and day medicine), and drug costs for people >65 years of age.

Health care costs of peritoneal dialysis technique failure and dialysis modality switching.

Background: Although there is a strong economic rationale in favor of peritoneal dialysis (PD) over hemodialysis (HD), the potentially costly effect of PD technique failure is an important consideration in PD program promotion that is unknown.

Study Design: Incident dialysis patients were categorized by initial and subsequent modality changes during the first year of dialysis and tracked for inpatient and outpatient costs, physician claims, and medication costs for 3 years using merged administrative data sets. We determined unadjusted and adjusted total cumulative costs for each modality group using multivariable linear regression models.

Economic analysis of epoetin alfa in critically ill trauma patients.

Background: Recent randomized control trials (RCTs) suggest that epoetin alfa reduces mortality in critically ill trauma patients; however, epoetin alfa is also costly and associated with adverse events. This study evaluates the cost-effectiveness of epoetin alfa in surgical trauma patients in an intensive care unit setting.

Methods: We constructed a decision analytic model to compare adjunctive use of epoetin alfa with standard care in trauma patients from the perspective of a Canadian payer.

Adding specialized clinics for remote-dwellers with chronic kidney disease: a cost-utility analysis.

Background And Objectives: This study aimed to determine whether opening a new clinic in a remote region would be a cost-effective means of improving care for remote-dwellers with CKD.

Design, Setting, Participants, & Measurements: This study is a cost-utility analysis from a public payer's perspective over a lifetime horizon, using administrative data from a large cohort of adults with stage 3b-4 CKD in Alberta, Canada. The association between the distance from each simulated patient's residence and the practice location of the closest nephrologist and clinical outcomes (quality of care, hospitalization, dialysis, and death) were examined.

The use of complementary and alternative medicines among patients with locally advanced breast cancer--a descriptive study.

Background: Complementary and alternative medicine (CAM) use is common among cancer patients. This paper reviews the use of CAM in a series of patients with locally advanced breast cancer (LABC).

Methods: Women with LABC attending a specialist clinic at a single Canadian cancer centre were identified and approached.