OBJECTIVES: This study was conducted to identify and compare resources and costs used by dialysis patients in Belgium. METHODS: The records of 130 patients undergoing dialysis were retrospectively reviewed to identify direct medical and non-medical resources used over year 2006. Data collected: baseline medical characteristics, dialysis-related information and resources used (hospitalizations, ambulatory care, medication, transport). Official tariffs were used for costing. RESULTS: Patients were hospitalized 1.5 ± 1.7 times for 18.1 ± 29.1 days. Laboratory tests were performed more frequently in hemodialysis (HD) patients than in peritoneal dialysis (PD) patients (295.6 ± 137.7 vs 120.1 ± 75.5; p‹0.0001). Patients on HD took more medications (12.4 ± 3.7 vs. 10.7 ± 4.3; p=0.0254). 79% of patients received EPO (average dose: 10,587 ± 14,114 IU). Patients on PD had more ambulatory consultations (9.7 ± 8.8 vs. 4.6 ± 8.9; p=0.0029) and interventions (5.8 ± 11.1 vs. 0.7 ± 1.1; p=0.0042). Only 11.6% of PD patients used an ambulance or transport organized by the dialysis center/sickness fund, compared with 67.8% for HD. The estimated annual cost for the public payer (PP) was €72,350 per HD and €55,343 per PD patient (i.e., 31% more). As in 2006 there were approximately 6400 patients on dialysis (90% on HD, 10% on PD), the PP total cost is estimated to be around €452 million (2.45% of 2006 health care budget). The dialysis procedure was the main cost driver (66% of costs) being 27% more expensive for HD. Hospital and ambulatory services were respectively 28% and 45% more expensive for HD. CONCLUSIONS: The economic burden of dialysis is important in Belgium. Considering that survival of PD patients is at least as good as that of HD patients and that home-treatment reduces exposure to hospital pathogens, PD represents good value for money and should be considered in more patients.