Cost advantages of peritoneal dialysis over haemodialysis in the first year of therapy

 
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Few studies have compared resource consumption and costs associated with haemodialysis (HD) and peritoneal dialysis (PD) access. Here we report results from a retrospective analysis titled: Cost analysis of haemodialysis and peritoneal dialysis access in incident dialysis patients1 comparing these treatments in the first year of therapy that may have important implications for policymakers.

Coentrao and colleagues performed a retrospective analysis of 152 chronic kidney disease patients receiving dialysis at a single Portugese centre. Results demonstrated that the resources required to establish and maintain dialysis access in the first year of treatment were lower for patients who chose PD over HD. In addition, PD was demonstrated to be a cost-effective option for incident dialysis patients.

Overall, results showed that:

  • PD patients had the lowest numbers of access surgeries and catheter-related interventions
  • HD with an arteriovenous fistula (HD-AVF) was associated with a higher number of access surgeries and diagnostic imaging procedures
  • HD with a tunneled cuffed catheter (HD-TCC) was associated with a higher number of catheter-related interventions and hospitalisations (mainly due to catheter-related infections).

Table 1. Dialysis access–related interventions* per patient year at risk


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*Mean ± standard deviation.

The mean dialysis access-related costs per patient year at risk were:

  • €1171.60 for PD
  • €1555.20 for HD-AVF (p<0.001 vs. PD)
  • €4208.20 for HD-TCC (p<0.001 vs. PD).

Although several studies have demonstrated the economic advantages of PD over HD, few have compared resource consumption and costs associated with HD and PD access. Thus, this study provides new insights into the cost advantages of establishing and maintaining a dialysis access during the first year of treatment – and may have important implications for policymakers.

To view the abstract, please click here.


References:

  1. Coentrao LA, Araújo CS, Ribeiro CA, Dias CC, Pestana MJ. Cost analysis of hemodialysis and peritoneal dialysis access costs in incident dialysis patients. Perit Dial Int 2013 May 1. [Epub ahead of print].