[Socioeconomic aspects of dialysis treatment]

The Italian research institute CENSIS recently estimated that the total monetary cost of dialysis in Italy reached almost 2,700 billion old lira (about 1.4 billion euros), with more than a quarter of that as social costs largely borne by families. The yearly cost in Italy for acetate and bicarbonate dialysis has been estimated at Euro 35,000 per patient and is steadily rising. Delaying renal death and start of dialysis by an average of two years is one of the most relevant ''monetary'' benefits of low-protein diets, even more so when considering that about half of all elderly patients starting dialytic treatment will die within three years. Reduced intake of phosphorus is another benefit of low-protein therapies that is associated with substantial monetary savings, thanks to a reduced need for phosphate-binding agents. Highly palatable preparations of low-protein content are already available, and are probably already self-paying if the savings from reduced prescription of phosphate binders are accounted for.