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Nickel M, Rideout W, Shah N, et al. Estimating patient-borne water and electricity costs in home hemodialysis: a simulation. CMAJ Open. 2017;5(1):E61-E65doi: 10.9778/cmajo.20160108.
Nickel, M., Rideout, W., Shah, N., Reintjes, F., Chen, J. Z., Burrell, R., & Pauly, R. P. (2017). Estimating patient-borne water and electricity costs in home hemodialysis: a simulation. CMAJ open, 5(1), E61-E65. https://doi.org/10.9778/cmajo.20160108
Nickel, Matthew, et al. "Estimating patient-borne water and electricity costs in home hemodialysis: a simulation." CMAJ open vol. 5,1 (2017): E61-E65. doi: https://doi.org/10.9778/cmajo.20160108
Nickel M, Rideout W, Shah N, Reintjes F, Chen JZ, Burrell R, Pauly RP. Estimating patient-borne water and electricity costs in home hemodialysis: a simulation. CMAJ Open. 2017 Feb 10;5(1):E61-E65. doi: 10.9778/cmajo.20160108. eCollection 2017. PMID: 28401120; PMCID: PMC5378499.
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CMAJ Open. 2017 Feb 10;5(1):E61-E65. doi: 10.9778/cmajo.20160108. eCollection 2017.

Estimating patient-borne water and electricity costs in home hemodialysis: a simulation.

CMAJ open

Matthew Nickel, Wes Rideout, Nikhil Shah, Frances Reintjes, Justin Z Chen, Robert Burrell, Robert P Pauly

Affiliations

  1. Department of Chemical and Materials Engineering (Nickel, Burrell), University of Alberta; Northern Alberta Renal Program (Rideout, Reintjes, Pauly), Alberta Health Services; Division of Nephrology, Department of Medicine (Shah, Pauly), University of Alberta; Department of Medicine (Chen), University of Alberta, Edmonton, Alta.

PMID: 28401120 PMCID: PMC5378499 DOI: 10.9778/cmajo.20160108

Abstract

BACKGROUND: Home hemodialysis is associated with lower costs to the health care system compared with conventional facility-based hemodialysis because of lower staffing and overhead costs, and by transferring the treatment cost of utilities (water and power) to the patient. The purpose of this study was to determine the utility costs of home hemodialysis and create a formula such that patients and renal programs can estimate the annual patient-borne costs involved with this type of treatment.

METHODS: Seven common combinations of treatment duration and dialysate flows were replicated 5 times using various combinations of home hemodialysis and reverse osmosis machines. Real-time utility (electricity and water) consumption was monitored during these simulations. A generic formula was developed to allow patients and programs to calculate a more precise estimate of utility costs based on individual combinations of dialysis intensity, frequency and utility costs unique to any patient.

RESULTS: Using typical 2014 utility costs for Edmonton, the most expensive prescription was for nocturnal home hemodialysis (8 h at 300 mL/min, 6 d/wk), which resulted in a utility cost of $1269 per year; the least expensive prescription was for conventional home hemodialysis (4 h at 500 mL/min, 3 d/wk), which cost $420 per year. Water consumption makes up most of this expense, with electricity accounting for only 12% of the cost.

INTERPRETATION: We show that a substantial cost burden is transferred to the patient on home hemodialysis, which would otherwise be borne by the renal program.

Conflict of interest statement

Competing interests: None declared.

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