Costing of Haemodialysis and Continuous Ambulatory Peritoneal Dialysis Procedures Performed at National Institute of Nephrology, Dialysis & Transplantation, Sri Lanka

Abstract

<strong>Introduction: </strong>Chronic Kidney Disease(CKD) is a rising epidemic. It is estimated that annually 1000 patients of End Stage Renal Failure are newly diagnosed. They require dialysis therapy, until kidney transplantation. Haemodialysis(HD) is the widely practiced dialysis method used today. The Continuous Ambulatory Peritoneal Dialysis(CAPD) is the other dialysis option. There are studies done on costing of HD, no such studies are available for CAPD in Sri Lanka. <strong> </strong> <strong>Objective: </strong>To compare the provider cost of HD and CAPD. performed at National Institute of Nephrology, Dialysis and Transplantation (NINDT) during the month of February 2016. <strong> </strong> <strong>Methodology: </strong>A descriptive cross sectional retrospective study, conducted among patients who underwent HD and CAPD for one month. Step down approach was used to calculate the costs. <strong> </strong> <strong>Results: </strong>Study reveals that the cost for a patient who undergoes HD for one month is Rs. 102,420. Cost for CAPD procedure for a patient during the 1st month was Rs 87,485 including the five day training. From the second month home based CAPD cost per month is Rs. 77,520. Most Asian countries adopt ‘CAPD first policy’ for Renal Replacement Therapy (RRT). With the increasing number of ESRF patients in Sri Lanka a need of rationalizing RRT exists. According to the study the annual cost for a HD patient is Rs1,229,040 and the same for CAPD patient is Rs 940,205. <strong> </strong> <strong>Conclusion: </strong>CAPD is 25% less costly than HD. <strong> </strong> <strong>Recommendation: </strong>Increase the facilities available for CAPD at more hospitals.