Utility values in diabetic kidney disease: a literature review

Curr Med Res Opin. 2015;31(7):1271-82. doi: 10.1185/03007995.2015.1041895. Epub 2015 May 29.


Objective: To summarize the published literature on utilities for health states associated with diabetic kidney disease (DKD), including end-stage renal disease (ESRD).

Research design and methods: A literature review was conducted (MEDLINE, MEDLINE in process, EMBASE, NHS EED, HEED, CEA Registry, EconLit, RePEc, and HTA) to identify relevant articles published between January 2000 and July 2013. Results were assessed for relevance by two reviewers in line with the study protocol.

Main outcome measures: For eligible studies, data extracted included patient population, health states, methods used to elicit utility values, and the source of the preference values.

Results: Twelve studies satisfied the inclusion criteria. They reported various utility and/or disutility scores for different DKD health states using a range of patient populations, utility approaches, and sources of preference values. The most common study country was the USA. Most of the studies collected data at one time point, but two had a longitudinal design. Three different utility instruments - EuroQoL (EQ-5D), Quality of Well-Being Scale (QWB), and 15-dimensional (15D) - were used to elicit utilities indirectly. The Time Trade-Off (TTO) approach was used in one study; another undertook a meta-analysis of published utility studies. Utilities were identified for different health states including DKD, ESRD-no dialysis, ESRD-dialysis, and transplant. One study reported utilities for patients by type of transplant. There was variation in values for the same health state between studies, and none of the studies reported utilities for the different stages of DKD. In the studies that undertook a comparison, utility values for those with DKD were generally found to be lower than those without DKD.

Conclusions: This literature review highlights that at present utility scores (or disutility penalties) exist for relatively few health states in DKD. Further studies are needed to produce accurate and comprehensive utility scores that differentiate between different DKD health states.

Keywords: Cost; Diabetes mellitus; Diabetic nephropathies; Review; Utilities; utility analysis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diabetic Nephropathies / physiopathology*
  • Diabetic Nephropathies / therapy
  • Humans
  • Kidney Failure, Chronic / etiology*
  • Kidney Failure, Chronic / therapy