Direct Cost for Treating Chronic Kidney Disease at an Outpatient Setting of a Tertiary Hospital- Evidence from a Cross-Sectional Study



Chronic kidney disease (CKD) has a high morbidity and mortality in developing countries. And this burden is also increasing rapidly in India. Unaffordability due to high cost of medication and hemodialysis remains one of the major barriers in the successful treatment of CKD.


To determine the direct cost involved in treating CKD at an outpatient department of a public tertiary care hospital.


This cross-sectional study was carried out at a public tertiary care hospital. Patients diagnosed with CKD by a physician were included in the study after obtaining a written informed consent. All the relevant data were collected on a predesigned case record form.


The results are based on data obtained from 150 patients. The average age of the patients was 55.7 ± 10.1 years. The average number of drugs per prescription was found to be 6.5 ± 1.7. The annual average costs of treatment for patients on medication only and for patients on hemodialysis plus medication were Rs 25,836 (US $386) and Rs 2,13,144 (US $3181), respectively (Rs = Indian rupee). Treatment cost was found to be statistically significantly higher in patients on hemodialysis, treatment support by employer, patients with a smoking habit, patients with comorbidities, and patients with end-stage renal disease. Calcium tablets, vitamin D sachets, iron supplements, torsemide, and amlodipine were the top five medications prescribed.


Reimbursement, patient’s dialysis status, habits, and comorbidities were found to have a significant effect on the direct cost of treatment.


Rajiv Ahlawat Pramil Tiwari Sanjay D’Cruz

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