Related Experiment Video

Updated: Jul 10, 2026

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
07:13

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

Cost Analysis for Home and Home-Assisted Renal Replacement Therapy Compared to In-Centre Hemodialysis

Lorenzo Aterini1, Gian Marco Caselli1, Costanza Gaudio1

  • 1SOC Nefrologia e Dialisi, Ospedale San Giovanni di Dio, Dipartimento Specialità Mediche, Azienda USL Toscana Centro, Firenze, Italy.

Giornale Italiano Di Nefrologia : Organo Ufficiale Della Societa Italiana Di Nefrologia
|July 9, 2026
PubMed

Insights

Home dialysis therapies, including assisted options, are more cost-effective than in-centre hemodialysis. This study highlights the economic viability of expanding home dialysis programs for chronic kidney disease patients.

Area of Science:

  • Nephrology
  • Health Economics
  • Renal Replacement Therapy

Background:

  • Chronic kidney disease (CKD) is a widespread condition necessitating dialysis, with facility-based hemodialysis being the most common treatment modality.
  • Understanding the cost implications of various dialysis modalities is crucial for healthcare system planning and resource allocation.

Purpose of the Study:

  • To estimate and compare the costs of in-centre hemodialysis/hemodiafiltration with home-based peritoneal dialysis and home hemodialysis.
  • To evaluate the cost-effectiveness of dialysis treatments, with or without healthcare staff assistance.

Main Methods:

  • A cost analysis was performed at a hospital in Florence, Italy, examining high- and low-flux bicarbonate hemodialysis (HD), hemodiafiltration (HDF), automated peritoneal dialysis (APD), continuous ambulatory peritoneal dialysis (CAPD), and daily home HD.
  • Monthly costs were calculated, encompassing direct medical expenses, indirect costs, personnel expenses, and patient transportation.

Main Results:

  • In-centre hemodialysis and hemodiafiltration incurred monthly costs of €4672 and €4766, respectively.
  • Home-based peritoneal dialysis (CAPD and APD) ranged from €1613 to €4454 monthly, depending on healthcare assistance.
  • Home hemodialysis costs were €2225 monthly without assistance and €4049 with assistance.

Conclusions:

  • Home-based dialysis modalities, including assisted treatments, present a more cost-competitive alternative to in-centre hemodialysis.
  • The findings suggest that expanding home dialysis programs is economically sustainable within the current healthcare framework.

Keywords:
assisted home dialysisdialysis costshome dialysishome dialysis costsin-centre hemodialysis

Related Concept Videos

Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
Hemodialysis III: Nursing Management01:25

Hemodialysis III: Nursing Management

The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this measurement...
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis01:30

Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis

Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...