限蛋白饮食治疗慢性肾脏病药物经济学评价

Cost-Utility Analysis of Protein-restricted Diet in Patients with Chronic Kidney Disease in China

目的 :为慢性肾脏病患者的蛋白饮食选择提供依据。方法 :使用Microsoft Excel模拟肾小球滤过率≤25ml/min/1.73m2的慢性肾脏病患者在三种蛋白饮食下5年的疾病进程,根据患者透析前后的治疗费用及生活质量,进行成本效用分析。结果 :极低蛋白饮食联合开同治疗与全蛋白和低蛋白饮食治疗相比,5年累计治疗费用分别节省180037.2元和163517.9元,QALYs分别延长0.349年和0.293年。结论 :限蛋白饮食可以延缓患者进入透析的时间,进而降低患者的疾病负担,改善患者生活质量。

Objective To provide basis for the selection of protein diet for patients with chronic kidney disease （CKD）. Methods By using Microsoft Excel to imitate the disease process of CKD patients with glomerular filtration rate ≤25ml/min/1.73m2 after taking three kinds of protein diets for the next 5 years, and based on the cost and the quality of life before and after dialysis, the cost-utility was analyzed. Results Very low protein diet combined with Ketosteril treatment, compared with total protein and low protein diet therapy, can save more than 180037.2 yuans and 163517.9 yuans of 5-year accumulative total treatment cost, respectively, and the QALY of CKD patients has been prolonged by 0.349 and 0.293 years, respectively. Conclusion Protein restricted-diet can delay CKD patients developed to the stage of dialysis, reduce their disease burden, and improve their quality of life.