Summary
The prevalence of end-stage renal disease continues to increase globally, and most
patients are treated with dialysis. Despite technological advances in dialysis care,
the relatively high costs of providing dialysis have not decreased substantially over
the past 4 decades. These 2 factors are a significant concern in this era of fiscal
restraint and finite health care budgets. Economic evaluation of dialysis treatment
consistently has shown that home-based hemodialysis and peritoneal dialysis are less
costly than in-center hemodialysis. Although only a portion of patients may be eligible
for this therapy, current use in Canada and the United States suggests that significantly
more patients could be treated with these therapies, which would result in significant
cost savings without compromising patient outcomes. There is some evidence to suggest
that the modality of home nocturnal dialysis may offer improvements in clinical outcomes
including quality of life, but further study of the cost effectiveness of this modality
is required.
Keywords
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References
- The direction of end-stage renal disease reimbursement in the United States.Semin Dial. 2004; 17: 125-130
- Kidney failure and the federal government.National Academy Press, Washington DC1991
- Cost effectiveness analysis applied to the treatment of chronic renal disease.Med Care. 1968; 6: 48-54
- The economics of end-stage renal disease care in Canada: incentives and impact on delivery of care.Int J Health Care Finance Econ. 2007; 7: 149-169
- The organization and financing of kidney dialysis and transplant care in the United States of America.Int J Health Care Finance Econ. 2007; 7: 301-318
- The social contract and the treatment of permanent kidney failure.JAMA. 1996; 275: 1123-1126
- U.S. Renal Data System, USRDS 2002 annual data report: atlas of end-stage renal disease in the United States.2002
- The costs of dialysis in the USA.Nephrol Dial Transplant. 1997; 12: 10-21
- Recent advances: nephrology.BMJ. 2000; 320: 98-101
- The costs of renal services in Britain.Nephrol Dial Transplant. 1997; 12: 25-28
- Historical national population estimates.2000
- Preliminary report for dialysis and transplantation 2008.Canadian Institute for Health Information, Ottawa2008
- A study of the quality of life and cost-utility of renal transplantation.Kidney Int. 1996; 50: 235-242
- Health economic evaluations: the special case of end-stage renal disease treatment.Med Decis Making. 2002; 22: 417-430
- Maintenance dialysis population dynamics: current trends and long-term implications.J Am Soc Nephrol. 2002; 13: S37-S40
- ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends.Nephrol Dial Transplant. 2005; 20: 2587-2593
- Economic evaluation.in: Detels R. Holland W.W. McEwan J. Oxford textbook of public health. 3rd ed. Oxford University Press, Oxford1997: 849-870
- QALY league tables: handle with care.Health Econ. 1993; 2: 59-64
- Cost-effectiveness league tables: valuable guidance for decision makers?.Pharmacoeconomics. 2003; 21: 991-1000
- Methods for the economic evaluation of health care programmes.Oxford University Press, Oxford1997
- Cost analysis of ongoing care of patients with end-stage renal disease: the impact of dialysis modality and dialysis access.Am J Kidney Dis. 2002; 40: 611-622
- Cost analysis of dialysis treatments for end-stage renal disease (ESRD).Clin Invest Med. 1995; 18: 455-464
- Gaining efficiencies: resources and demand for dialysis around the globe.Value Health. 2009; 12: 73-79
- Cost savings of home nocturnal versus conventional in-center hemodialysis.Kidney Int. 2002; 62: 2216-2222
- An operating cost comparison between conventional and home quotidian hemodialysis.Am J Kidney Dis. 2003; 42: 49-55
- The case for daily dialysis: its impact on costs and quality of life.Am J Kidney Dis. 2001; 37: 777-789
- Nocturnal haemodialysis: an Australian cost comparison with conventional satellite haemodialysis.Nephrology (Carlton). 2005; 10: 557-570
- The economics of home nocturnal hemodialysis: how should we cost the benefits?.Clin Nephrol. 2007; 68: 151-158
- Reducing hemodialysis costs: conventional and quotidian home hemodialysis in Canada.Semin Dial. 2004; 17: 118-124
- Effect of starting with hemodialysis compared with peritoneal dialysis in patients new on dialysis treatment: a randomized controlled trial.Kidney Int. 2003; 64: 2222-2228
- Comparing mortality rates on CAPD/CCPD and hemodialysis.Perit Dial Int. 1998; 18: 478-484
- Comparing the risk for death with peritoneal dialysis and hemodialysis in a national cohort of patients with chronic kidney disease.Ann Intern Med. 2005; 143: 174-183
- Hemodialysis versus peritoneal dialysis: a comparison of adjusted mortality rates.Am J Kidney Dis. 1997; 30: 334-342
- Mode of dialysis therapy and mortality in end-stage renal disease.J Am Soc Nephrol. 1998; 9: 267-276
- A comparison of mortality between patients treated with hemodialysis and peritoneal dialysis.J Am Soc Nephrol. 1995; 6: 177-183
- Mortality risks of peritoneal dialysis and hemodialysis.Am J Kidney Dis. 1999; 34: 1065-1074
- The “unphysiology” of dialysis: a major cause of dialysis side effects?.Kidney Int Suppl. 1975; 2: 30-34
- Optimal dialysis frequency and duration: the “unphysiology hypothesis.”.Kidney Int Suppl. 1978; 8: S120-S124
- Early clinical, quality-of-life, and biochemical changes of “daily hemodialysis” (6 dialyses per week).Am J Kidney Dis. 2004; 43: 90-102
- Improvement in ejection fraction by nocturnal haemodialysis in end-stage renal failure patients with coexisting heart failure.Nephrol Dial Transplant. 2002; 17: 1518-1521
- Regression of left ventricular hypertrophy after conversion to nocturnal hemodialysis.Kidney Int. 2002; 61: 2235-2239
- Volume control and blood pressure management in patients undergoing quotidian hemodialysis.Am J Kidney Dis. 2003; 42: 13-17
- The quality of life and cost utility of home nocturnal and conventional in-center hemodialysis.Kidney Int. 2003; 64: 1004-1011
- Patient quality of life on quotidian hemodialysis.Am J Kidney Dis. 2003; 42: 36-41
- A systematic review of the effect of nocturnal hemodialysis on blood pressure, left ventricular hypertrophy, anemia, mineral metabolism, and health-related quality of life.Kidney Int. 2005; 67: 1500-1508
- Effect of frequent nocturnal hemodialysis vs conventional hemodialysis on left ventricular mass and quality of life: a randomized controlled trial.JAMA. 2007; 298: 1291-1299
- The effects of nocturnal hemodialysis compared to conventional hemodialysis on quality of life: a randomized controlled trial.Kidney Int. 2009; 75: 542-549
- Cost-effectiveness of frequent in-center hemodialysis.J Am Soc Nephrol. 2008; 19: 1792-1797
- Status of renal replacement therapy and peritoneal dialysis in Mexico.Perit Dial Int. 2007; 27: 142-148
- USRDS 2008 annual data report: atlas of chronic kidney disease and end-stage renal disease in the United States.National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda2008 ([cited 2008 Dec 18])
- Economic evaluation of end stage renal disease treatment.Health Policy. 1998; 44: 215-232
- Medical professionalism in the new millennium: a physicians' charter.Lancet. 2002; 359: 520-522
Article info
Footnotes
Supported by a Scholarship Award from the Kidney Foundation of Canada, and a Population Health Investigator Award from the Alberta Heritage Foundation for Medical Research (S.K.); and supported by a Canadian Institutes of Health Research New Investigator Award (B.M.).
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
