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Abstract: FR-PO542

Cost-Utility of Real-Time Potassium Monitoring in Hemodialysis Patients

Session Information

Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders

  • 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical


  • Bamforth, Ryan J., Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Ferguson, Thomas W., Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Komenda, Paul, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada

Patients with kidney failure requiring dialysis are at high risk for hyperkalemia, a result of elevated levels of potassium, which is associated with increased morbidity and mortality. Interventions aimed at early detection of hyperkalemic events may be useful to prevent these outcomes and their associated costs. As such, we performed a cost-utility analysis comparing an intervention where a real-time potassium monitoring device is administered in hemodialysis patients in comparison to usual care.


We performed a cost-utility analysis by developing a decision analytic microsimulation model from the perspective of the United States health care payer. Outcomes included the monthly break-even cost per patient of the proposed intervention and the incremental cost-effectiveness ratio (ICER) comparing use of the real-time potassium monitoring device to usual care. Costs associated with hyperkalemic events (emergency department and hospitalization specific) and dialysis were included. Utility estimates from a systematic review and meta-analysis were used to derive utilities for patients on hemodialysis. A reduction in hyperkalemic events of 25% was applied in the intervention scenario as a baseline effectiveness estimate, with a range between 10-50% considered in sensitivity analyses.


Threshold analysis yielded a monthly break-even cost of $689.56 US dollars per patient in the base case scenario. In addition, the microsimulation model found the intervention provided 0.04 additional quality-adjusted life-years (QALYs), and as such at any price point below or equal to the break-even cost the intervention was dominant in comparison to usual care. When altering effectiveness estimates between a reduction of hyperkalemic events between 10% to 50%, the monthly break-even cost ranged from $265.36 to $1387.90 USD respectively.


Implementing a real-time potassium monitoring device in hemodialysis patients to prevent hyperkalemic events has the potential for cost savings and increased quality of life from the perspective of the Unites States health care payer.


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