OBJECTIVES

: To determine, from payer’s perspective, the Continuous Renal Replacement Therapy (CRRT) economic impact among patients with acute kidney injury (AKI) requiring dialysis.

METHODS

: A Cost-Consequence Analysis in 1,460 patients based on the calculated monthly incidence for the Mexican Social Security Institute (IMSS), according to IMSS (2017) published data, Kohle (2015) and Susantitaphong et al (2013).

This analysis considers two temporal horizon scenarios:

• Short term: Considers the direct impact of length between AKI diagnosis and hospital discharge, measuring the Length of Stay (LOS) based on Serum Creatinine (SCr) increments and hospital stay association, applying the data published by Mehta (2007)For this scenario In-hospital Hemodialysis was considered as the Intermittent Therapy Alternative assuming 2-days treatment for the AKI event for both alternatives.
• Medium- term: Due to one of the most important consequences between therapies is the transition for Dialysis Dependence, this consider up to 1 year after discharge follow up, measuring the number of Dialysis Dependent (DD) patients who were treated for AKI in the cohort, according to the proportions published by Uchino (2001).For DD patients, in a Chronic Kidney Disease (CKD), out of hospital Hemodialysis is considered as the Renal Replacement Therapy (RRT), with 3 weekly sessions.

According to these scenarios, the overall cost for AKI treatment was calculated to establish the best clinical and economical treatment option for AKI patients.

RESULTS

: Of the 1,460 patients, CRRT results in an alternative that brings savings in the treatment of AKI, with overall savings of 11% against IRRT ($16,594,491 vs $18,352,842), besides an incremental cost in the direct treatment of AKI ($5,837,400 vs $706,325), Hospitalization costs ($10,072,434 vs $15,404,899) and Dialysis Dependence Cost ($684,657 vs $2,241,618) are favorable to generate savings for CRRT as an initial RRT.

CONCLUSIONS

Under the Mexican HealthCare System pespective, CRRT is an efficient treatment for AKI, shown by this Cost-consequence analysis.