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12-06-2012 | General practice | Article

Increasing water intake ‘cost-effective way to prevent kidney stones’


Free abstract

MedWire News: The primary prevention of nephrolithiasis with increased fluid intake is cost-effective for a national healthcare system, research shows.

High water intake by the entire population would translate into a cost savings of more than € 270 million (US$ 338 million) and prevent nearly 10,000 cases of kidney stones.

"Even if only 25% of the population is compliant, there is still a cost saving of € 68 million and 2316 stones," report Yair Lotan (University of Texas Southwestern Medical Center, Dallas, Texas, USA) and colleagues.

Recurrence of nephrolithiasis is common, affecting around half of patients over a 5-year period. Increased fluid intake can cut this rate by as much as 50%, but few studies have so far investigated the effectiveness of preventing stone disease in patients without a prior history.

As reported in the British Journal of Urology International, the researchers conducted a healthcare system-wide analysis to estimate the cost-effectiveness of high-water intake (>2 L/day) versus low-water intake (<2 L/day).

The researchers estimated the annual incidence of nephrolithiasis in the general population to be 0.003% and assumed a 40% reduction in risk for stones with the increased water intake. The incidence of stones was based on estimates from France where there are approximately 21,000 cases among a population of 65 million people.

The total cost of nephrolithiasis was € 4267 ($ 5345) in the base-case analysis, with direct costs of € 2767 ($ 3467) that include the cost of treatment and complications.

Based on the population of France, the annual budget cost was € 590 million ($ 739 million) for the payer. For one patient treated for 25 years, increasing water intake can save the payer an average of € 30 ($ 38) per person.

Increasing water intake 100% in the entire population would result in a cost savings of € 273 million ($ 342 million) and 9265 fewer stones.

According to Lotan and colleagues, the analysis likely underestimates the true savings that can occur over time as there would also be a reduction in the long-term consequences of stone disease, such as chronic kidney disease.

In an editorial, Roger Sur (University of California, San Diego, USA) suspects the savings would be even higher in other healthcare systems, such as in the USA, given that healthcare costs are higher in other countries.

"The findings underscore the importance of the most basic education we should and have been giving our stone patients - drink more water," writes Sur.

By MedWire Reporters

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