Potential life-years gained over a 5-year period by correcting DOPPS-identified modifiable practices in haemodialysis: results from the European MONITOR-CKD5 study

Christian Combe, Johannes Mann, David Goldsmith, Frank Dellanna, Philippe Zaoui, Gérard London, Kris Denhaerynck, Andriy Krendyukov, Ivo Abraham, Karen MacDonald, Christian Combe, Johannes Mann, David Goldsmith, Frank Dellanna, Philippe Zaoui, Gérard London, Kris Denhaerynck, Andriy Krendyukov, Ivo Abraham, Karen MacDonald

Abstract

Background: DOPPS reported that thousands of life-years could be gained in the US and Europe over 5 years by correcting six modifiable haemodialysis practices. We estimated potential life-years gained across 10 European countries using MONITOR-CKD5 study data.

Methods: The DOPPS-based target ranges were used, except for haemoglobin due to label changes, as well as DOPPS-derived relative mortality risks. Percentages of MONITOR-CKD5 patients outside targets were calculated. Consistent with the DOPPS-based analyses, we extrapolated life-years gained for the MONITOR-CKD5 population over 5 years if all patients were within targets.

Results: Bringing the 10 MONITOR-CKD5 countries' dialysis populations into compliance on the six practices results in a 5-year gain of 97,428 patient-years. In descending order, survival impact was the highest for albumin levels, followed by phosphate levels, vascular access, haemoglobin, dialysis adequacy, and interdialytic weight gain.

Conclusions: Optimal management of the six modifiable haemodialysis practices may achieve 6.2% increase in 5-year survival.

Trial registration: NCT01121237 . Clinicaltrials.gov registration May 12, 2010 (retrospectively registered).

Keywords: Anaemia; Biosimilar epoetin alfa; Haemodialysis; Life-years; Modifiable haemodialysis practices.

Conflict of interest statement

Ethics approval and consent to participate

The MONITOR-CKD5 study protocol was approved by the ethical review committees of participating centres in accordance with national laws and regulations. The central ethical review committees included Ethics Committee of the Ärztekammer Nordrhein (Düsseldorf, Germany), Ethics Committee of the Hospital-University Policlinico-Vittorio Emanuele of Catania (Catania, Italy), Independent Bioethics Committee for Scientific Research at GU Med (Gdańsk, Poland), National Agency for Medicines and Medical Devices (Bucuresti, Romania), Institute of Clinical Neurophysiology, Clinical Center Ljubljana (Ljubljana, Slovenia), Health Counseling General Secretary of Quality and Modernization, Autonomic Committee of Clinical Trials (Sevilla, Spain), and Cambridgeshire 1 Research Ethics Commitee (Cambridge, England); a complete list of all review boards including local ethical review committees is available as a supplementary online file (i.e., “Additional file 1”). Written informed consent was obtained from all participating patients.

Consent for publication

Not applicable because this report does not contain data for individual patients.

Competing interests

CC, JM, DG, FD, PZ, and GL received compensation from Hexal AG for their participation in the work reported here. AK is an employee of Hexal AG. KD, KM, and IA are affiliated with Matrix45; by company policy, they cannot hold equity in sponsor organizations and cannot receive direct personal benefits, financial or other, from sponsor organizations. Matrix45 provides similar services to other biopharmaceutical companies without exclusivity constraints.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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