Given the impact of ESRD on patients’ quality of life,
and the high level of expenditure on RRT, there is a need
for further analysis on the potential for improved outcomes
and cost savings through enhanced strategies to
reduce progression rates to ESRD. For example, modelling
based on the figures in this paper suggests that
ACEI/ARB prescribing for patients with hypertension
400 and proteinuria produces a mean annual net saving to the
NHS of ∼£470 per treated patient over a 5-year perspective.
This saving arises through reduced ESRD, stroke and
MI risk. QOF data indicate that, in 2009–10, 82
834 people with hypertension and proteinuria (6.1% of
405 those who had an ACR or PCR test) were treated with
ACEIs/ARBs. The net annual saving for this group, over
a 5-year perspective, is estimated at £39 million.