The economic cost of dialysis: a comparison between peritoneal dialysis and in-center hemodialysis in a Spanish unit.

We have studied the economic cost of dialysis therapy in our area (public setting) during 1994, comparing the cost of different modalities of in-center hemodialysis (HD) and home peritoneal dialysis (PD). Analyzed costs included: personnel, drug expenditure, disposable (dialysis- and non-dialysis-related), laboratory, other services, indirect costs, maintenance and redemption, hospital admissions, transport, and home supplies. The final cost per patient and year (in 1994 US$) was: hemodiafiltration (AN69 filter, bicarbonate buffer) $58,890; HD polymethylmethacrylate filter and bicarbonate buffer $55,076; HD cuprophane and acetate buffer $49,767; CAPD $31,201; and cost of automated PD $42,519. The main expenditure sections were: home supply and hospital admissions for PD patients, and personnel, drug expenditures, disposable dialysis material, indirect costs, hospital admissions, and transport for HD patients. Home peritoneal dialysis therapy has a significantly lower economic cost than any in-center HD modality.