OBJECTIVES: Comparison of cost-effectiveness of peritoneal dialysis (PD) and hemodialysis (HD) in treatment for patients with chronic renal disease in the Russian Federation. METHODS: We used the methods of the pharmacoeconomic analysis: effectiveness analysis, analysis of the direct and indirect costs, cost-effectiveness analysis. Direct costs included the costs of patient preparation to renal replacement therapy (RRT) and the costs of the conduct of  RRT, also the costs of treatment infectious complications of RRT (sepsis, peritonit) and  complications chronic renal disease (anemia, cardiovascular disease, secondary hyperparathyroidism). Indirect costs included the lump sum disability benefits, disability annuities (subject to the degree of disability) and loss of the gross domestic product because of the disablement of patients of economically active age. RESULTS: The total cost treatment per one patient with chronic renal disease amounted to 18 876 $ to the PD group and 21 493 $ to the HD group. The results of cost analysis showed that  the conduct of the RRT as on PD, and on HD has largest share of spending in the structure of the total cost of treatment of the patients with chronic renal disease. The annual average costs of PD treatment of one typical patient are lower by 12 % as compared to HD treatment; this results in the lower costs of treatment of complications of chronic renal disease and the RRT, and lower indirect costs due to longer preservation ability to work. Treatment on the PD produced higher cumulative quality-adjusted life-years (QALYs; 0.65) than HD (0.44). Thus the cost-effectiveness ratio on the PD was 29 040 $, on the HD 48 847 $ (1 $ = 76 RUB.) CONCLUSIONS: The result of the cost-effectiveness analysis demonstrated that PD is a dominant therapy.