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Kidney Week

Abstract: SA-PO657

Is the Cost of the New Home Dialysis Techniques Still Advantageous Compared to In-Centre Hemodialysis?

Session Information

  • Home Dialysis - II
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 802 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • Roccatello, Dario, University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases, Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley, San Giovanni Bosco Hub Hospital, University of Turin, Turin, Italy
  • Fenoglio, Roberta, University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases, Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley, San Giovanni Bosco Hub Hospital, University of Turin, Turin, Italy
  • Sciascia, Savino, University Center of Excellence on Nephrologic, Rheumatologic and Rare Diseases, Coordinating Center of the Interregional Network for Rare Diseases of Piedmont and Aosta Valley, San Giovanni Bosco Hub Hospital, University of Turin, Turin, Italy
Background

Three main factors should be considered in the economic evaluation of home dialysis: the progressive reduction in the cost of consumables for in-centre hemodialysis (IC-HD), the widespread use of incremental Peritoneal Dialysis, and the renewed interest in Home Hemodialysis (H-HD). Registries data on incidence and prevalence of dialysis modalities are heterogeneous, showing widespread underemploy of home dialysis. Based on results in clinical and quality of life benefits, underemploy could be no more justified.

Methods

We compared the direct and indirect costs of PD (53 patients), H-HD (21 patients) and IC-HD (180 patients) by measuring the dialysis activity performed from January 1, 2019 to December 31, 2019 at the San Giovanni Bosco Hub Hospital, Turin (Italy). A cost analysis of the different dialysis techniques (DP and HD, home and hospital) was also carried out.

Results

To obtain comparable weekly costs, the following strategy was applied: a) calculating the average weekly frequency of dialysis sessions based on the dialysis modality. b) normalizing the cost of individual sessions per patient per week. c) calculating the monthly and yearly costs.
PD proved to be the least expensive (€ 23,314.79 per patient per year), while H-HD has a lower average cost than IC-HD (€ 35,535.00 vs € 40,798.98).

Conclusion

Our data analysis confirms the low cost of Continuous Ambulatory PD and PD. Compared to all other hemodialysis modalities and even Automated Peritoneal Dialysis, Home Bicarbonate Hemodialysis has the lowest costs and the weekly cost of Frequent Home Hemodialysis was found to be comparable to that of In-Centre Bicarbonate Hemodialysis.