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To date, cost studies for chronic kidney disease (CKD) have primarily focused on direct costs. It has been documented that peritoneal dialysis (PD) is more cost-effective than hemodialysis (HD); however, the impact of patient and caregiver time spent on treatment is not included. Objective: To estimate the indirect costs and out-of-pocket expenses of CKD on PD compared to HD in Bogotá, Colombia
A cost analysis study was conducted. Out-of-pocket expenses were estimated by the weighted average of monthly events per reported dialysis-related expenditure. Indirect cost was estimated on a monthly basis, taking into account transportation time, dialysis procedure time, and perceived patient and caregiver disability. Univariate and multivariate analyses were performed to compare costs between PD and HD. A significance level of p < 0.05 was considered.
We included 132 patients, 40 on PD and 92 on HD, with a median age of 61 years (IQR: 43.7-72.25), of which 43.9% were female. Patients on PD reported being more occupationally active than those on HD (p = 0.028). A catastrophic expenditure was reported by 28.2% of the cohort. The median out-of-pocket expense was COP 477,907 (IQR 235,038-851,698) per month, with no differences between therapies (p = 0.17). Indirect costs were higher in HD, with COP 1,903,125 (IQR 894,922-3,262,500), compared to PD, with COP 652,500 (IQR 199,375-2,175,000) (p = 0.0002).
Indirect costs are higher in HD compared to PD. A larger sample size is required to identify differences in out-of-pocket expenses and between types of PD.