Projected Cost-beneficial Impact of the Selective Cytopheretic Device in Pediatric Acute Kidney Injury Requiring Kidney Replacement Therapy

Rationale & ObjectiveThe Selective Cytopheretic Device for Pediatrics (SCD-PED) is a cell-directed extracorporeal therapy approved by US FDA for pediatric patients with acute kidney injury (AKI) due to sepsis or a septic condition, requiring antibiotics and continuous renal replacement therapy (CRRT). This study aimed to estimate hospitalization costs and outcomes of SCD-PED therapy by leveraging the Kids Inpatient Database (KID) and SCD-PED studies. Study DesignPublicly available hospitalization cost data were combined with clinical metrics from prior SCD-PED studies to assess the impact of SCD-PED on inpatient hospital costs among pediatric patients receiving CRRT. Setting & PopulationThe SCD-PED was evaluated in two multicenter pediatric studies, involving 16 and 6 patients, respectively. Pediatric patients with AKI and multi-organ dysfunction receiving CRRT as part of standard care were included. The KID subset comprised hospitalizations with CRRT, a length of stay (LOS) up to 60 days, mortality and severity level 4, an AKI diagnosis, and total parenteral nutrition (TPN) procedures. InterventionsPatients received SCD-PED therapy for up to 7 or 10 days or until CRRT termination. OutcomesOutcomes analyzed included hospital LOS, mortality, vasopressor use, mechanical ventilation, sepsis diagnosis, number of SCD-PED devices used, and hospitalization cost estimates. Model, Perspective, & TimeframeA regression-based economic cost model compared costs between SCD-PED therapy and theoretical controls, adjusted to 2024 US dollars. ResultsModeled hospitalization costs were $457,092 in the KID cohort and $389,451 in the ppCRRT cohort. Median hospital LOS was lower in the SCD-PED group (28 days vs. 31 days), resulting in lower estimated costs ($320,304) and an estimated savings of $69,146 per hospitalization. LimitationsSmall sample sizes and single-arm design with no prospective control arm. Reported costs are estimates based on models. ConclusionsThe SCD-PED shows potential for survival benefit and cost-benefit in critically ill children with AKI requiring CRRT, including those with sepsis.