title: Cost analysis and sociocultural profile of kidney patients. Impact of the treatment method.
abstract: BACKGROUND
  The cost analysis of chronic kidney disease based on individual data for treatment methods and components has not been published in Spain.
  
  
  OBJECTIVE
  a) To study the health costs of a year of treatment with haemodialysis (HD), deceased donor renal transplantation (RTx), renal-pancreas transplantation (RPTx), and S4 and S5 advanced chronic kidney disease (ACKD) b) Assess the potential relationship between sociocultural diversity, costs and treatment method.
  
  
  METHODS
  Observational study of: 1) 81 patients with ACKD (53 S4 and 28 S5) 2) 162 with more than 3 months on HD and 3) 173 with a Tx for more than 6 months (140 RTx and 33 RPTx). The costs were assessed in five categories: 1) HD sessions, 2) drug intake, 3) hospitalisation, 4) outpatient care and 5) transportation. We carried out a survey with socio-demographic parameters.
  
  
  RESULTS
  The financial impact of HD was €47,714&plusmn;18,360 (mean&plusmn;SD), that of Tx €13,988&plusmn;9970, and that of ACKD €9654&plusmn;9412. The cost of HD was the highest in all financial items. The costs were similar between RTx and RPTx. In ACKD, the greater the renal deterioration, the greater the cost is (S4 €7846&plusmn;8901 versus S5 €13,300&plusmn;9820, P<.01). Tx patients had the best sociocultural status, while HD patients had the worst profile. We did not find differences in costs between the three sociocultural groups.
  
  
  CONCLUSIONS
  HD has the greatest financial impact in all items, five times higher than the ACKD patient cost and three times than the Tx patient cost. Optimising early prevention and Tx, if appropriate, must be priority strategies. This analysis invites us to think about whether sociocultural status can have an influence on opportunities for Tx.
authors.forename: Víctor
authors.initials: V
authors.lastname: Lorenzo-Sellares
authors.forename: M Inmaculada
authors.initials: MI
authors.lastname: Pedrosa
authors.forename: Balbina
authors.initials: B
authors.lastname: Santana-Expósito
authors.forename: Zoraida
authors.initials: Z
authors.lastname: García-González
authors.forename: Mónica
authors.initials: M
authors.lastname: Barroso-Montesinos
mesh_terms: D000368:Aged; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000191:economics* / Q000628:therapy*; D012959:Socioeconomic Factors