Fig 1.
The inflow of the model was built based on the annual incidence of CKD stage 3a and the estimated growth in the Chilean adult population. The progression of CKD was determined by the estimated glomerular filtration rate (eGFR) levels calculated using the CKD-EPI equation. Progression could be decrements of 5, 3 or 1.4 ml/min/1.73 m2 per cycle depending on the presence of diabetes and/or increased albuminuria. Patients can progress to another stage or remain in the same health state. Death could occur from any stage.
Table 1.
Input values used for the stock and flow model.
Table 2.
Total annual costs per patient used for the stock and flow model.
Fig 2.
Expected number of cases and costs per year and CKD stage.
Estimation of cases and costs of CKD to 2041. A: Estimation of cases of CKD by stage and year to 2041. B: Estimation of costs (in Million GBP) of CKD by stage and year to 2041.
Table 3.
Projection of the future number of Chilean adults with CKD by stage for years 2021–2041.
Table 4.
Projection of the future costs (in million GBP) of CKD by stage for years 2021–2041.
Fig 3.
Expected number of cases per year, CKD stage and scenario.
Comparison of expected number of cases between the two scenarios included in the study. The difference in the proportion of fast, medium and slow progressors between stages creates a difference in the distribution of individuals between them. In the baseline scenario individuals progress faster, thus the number of individuals in RRT by the end of 2041 is higher. Conversely, in the scenario that includes treatment with SGLT2 inhibitors for individuals with CKD stages 3a and 3b with diabetes mellitus, and pre-dialysis treatment for individuals with CKD stage 4 and 5, there would be a lower number of individuals in RRT by the end of 2041.
Fig 4.
Expected costs per year, CKD stage and scenario.
Comparison of expected costs (in Million GBP) between the two scenarios simulated in the study. The difference in the proportion of fast, medium and slow progressors between stages creates a difference in the distribution of individuals between them and therefore the healthcare costs. In the baseline scenario, with a greater number of individuals progressing faster to RRT, the total costs of CKD projected to 2041 is higher compared to the scenario with the inclusion of SGLT2 inhibitors for individuals with CKD stages 3a and 3b and with diabetes mellitus, and pre-dialysis treatment for individuals with CKD stages 4 and 5.