Economic impact of vitamin D treatment on chronic kidney disease patients

Nefrologia. 2011;31(5):528-36. doi: 10.3265/Nefrologia.pre2011.Aug.11012.
[Article in English, Spanish]

Abstract

During recent years, increasing recognition has been given to the endocrine action that vitamin D has on the extraskeletal system, and its deep involvement in CKD. This has meant that many vitamin D compounds (both nutritional and active) have been made available, with an important cost reduction. This review looks at the evidence available regarding the usefulness of different types of vitamin D (nutritional and active) for patients with stage 3-5 CKD and those undergoing dialysis. Emphasis is given to its usefulness to control hyperparathyroidism and its impact on morbidity and mortality. We also analysed pharmacoeconomic studies that have been published which compare active vitamin D metabolites. From this review, we are able to conclude that there is still not enough scientific evidence to be able to prefer one active vitamin D over another. In the meantime, doctors should follow the recommendations given in clinical practice guidelines, always taking into account their personal experience with patients. Furthermore, they must consider the economic impact that their treatment decisions may have.

MeSH terms

  • Animals
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Chronic Disease
  • Chronic Kidney Disease-Mineral and Bone Disorder / drug therapy
  • Chronic Kidney Disease-Mineral and Bone Disorder / economics
  • Chronic Kidney Disease-Mineral and Bone Disorder / etiology
  • Chronic Kidney Disease-Mineral and Bone Disorder / prevention & control*
  • Clinical Trials as Topic
  • Cohort Studies
  • Cost Savings
  • Humans
  • Hyperparathyroidism, Secondary / drug therapy
  • Hyperparathyroidism, Secondary / economics
  • Hyperparathyroidism, Secondary / etiology
  • Hyperparathyroidism, Secondary / prevention & control
  • Inflammation / drug therapy
  • Kidney Diseases / drug therapy*
  • Kidney Diseases / economics
  • Meta-Analysis as Topic
  • Paracrine Communication
  • Practice Guidelines as Topic
  • Rats
  • Receptors, Calcitriol / agonists
  • Vitamin D / chemistry
  • Vitamin D / economics
  • Vitamin D / metabolism
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / metabolism

Substances

  • Receptors, Calcitriol
  • Vitamin D