Thus, the resources to be allocated to RRT are increasing. īecause the worldwide incidence of kidney failure continues to rise and treatment is costly, the global burden of illness is growing. By the year 2010, it is expected that the number of dialysis patients will approach two million. The global average prevalence for dialysis was 215 patients per million population, although significant regional variations existed. Of those patients 77% were on dialysis and 23% were living with a functioning kidney transplant. Worldwide, at the end of 2004, ∼1 800 000 patients were receiving RRT. Patients with kidney failure require renal replacement therapy (RRT), either a kidney transplant or dialysis, to maintain life. Patients suffering from chronic kidney disease can be classified according to kidney function along a continuum from mild renal dysfunction to irreversible kidney failure. Additional research is needed in the developing world before conclusive statements may be made regarding the relative costs of HD and PD. In developed countries, HD is generally more expensive than PD to the payer. A key factor to consider in reviewing cost comparisons is the perspective of the analysis because different costs are relevant for different perspectives. Many cost comparisons of dialysis modalities have been conducted. PD is driven mainly by variable costs such as solutions and tubing, while HD is driven mainly by fixed costs of facility space and staff. Modality selection is influenced by employment status, with an association between being employed and PD as the modality choice. In certain countries, there is interest in revising the reimbursement structure to favour home-based therapies, including PD and home HD. Regarding resource availability, when centre HD capacity is high, there is an incentive to use that capacity rather than place patients on home dialysis. In general, where there is little or no facility or physician reimbursement or payment for PD, the share of PD is very low. Important economic factors influencing dialysis modality selection include financing, reimbursement and resource availability. Alternative dialysis modalities are haemodialysis (HD) and peritoneal dialysis (PD). This review focuses on the economics of dialysis. Kidney failure patients require either a kidney transplant or dialysis to maintain life. The worldwide incidence of kidney failure is on the rise and treatment is costly thus, the global burden of illness is growing.
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