Renal replacement therapies in intensive care units: cost analysis

The medical treatment of intensive care unit patients represents one of the greatest costs in the health care system. Patients affected by acute renal failure account for about -10% of cases: dialysis treatment is of major importance in an economical setting. Recent studies compared continuous renal replacement therapy (CRRT) with intermittent hemodialysis (IHD). Cost comparison of the two methods showed that CRR is more expensive due to the technical device costs, while the intermittent dialysis costs depended mostly on human resources management, e.g. a longer time spent for nurse and hemodyalisis surveillance. Moreover, a higher dialysis dose, easily obtained with CRRT, could improve survival and renal function recovery leading to a reduction in hospitalization and consequently minor health care costs. These parameters, if opportunely evaluated and verified through randomized multicentric trials, could lead to an economical balance between CRRT and IHD; nephrologists, then, could choose a method out of medical and clinical more than economic reasons.