[Cost utility of renal transplant vs. hemodialysis in the treatment of end stage chronic kidney failure in a Peruvian hospital].

Objectives: 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.

Materials And 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.