title: [Cost utility of renal transplant vs. hemodialysis in the treatment of end stage chronic kidney failure in a Peruvian hospital].
abstract: OBJECTIVE
  To assess and compare the cost utility of the cadaveric donor renal transplant (CDRT) at the Hospital Nacional Guillermo Almenara Irigoyen between 2000 to 2001, against haemodialysis (HD), 5 years after treatment initiation.
  
  
  METHODS
  A cost utility study design was used, which evaluated every patient continuing treatment after 5 years of having the CDRT done, and 2 controls consisting in patients having received HD for 5 years, matched by age, sex and disease duration. The costs of each procedure and their Quality-adjusted life years (QALY´s) were evaluated using the questionnaire of quality of life SF-36v2(TM), finally calculating the cost utility (CU) and incremental cost utility (ICU) ratios.
  
  
  RESULTS
  Fifty-eight CDRT were performed between 2000-1. Five years later, 17 (29%) patients died and only 27 (47%) continued the treatment after CDRT. Out of the 31 patients (53%) having treatment failures, 26% rejected the transplant, 55% presented a complication and 19% were irregular. The mean SF-36v2(TM) scores obtained by the CDRT and HD patients were 95±12 and 87±18 points, respectively. The QALYs obtained by the CDRT and HD groups were 251 and 229 points, respectively; the CU ratios for the CDRT and HD were USD 11,984 and USD 9,243; and the ICU ratio for the period was USD 40,669.
  
  
  CONCLUSIONS
  CDRTs performed during the years 2000-1 at the HNGAI, were 5 years later surprisingly less cost effective than the HD and CDRT´s performed at year 2000 had a lower incremental cost utility ratio that those performed the 2001, probably because of the highest rate of irregular treatment.
authors.affiliation: Servicio de Nefrología, Hospital Nacional Guillermo Almenara Irigoyen, EsSalud, Lima, Perú.
authors.forename: Ricardo E
authors.initials: RE
authors.lastname: Loza-Concha
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Quispe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006761:Hospitals; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000628:therapy*; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010568:Peru; D006435:Renal Dialysis / Q000191:economics*; D055815:Young Adult