Skip to main content Skip to main navigation menu Skip to site footer

Cost-effectiveness of hemodialysis, peritoneal dialysis and kidney transplantation at dr Sadjito General Hospital in 2018-2020

  • Fitra Hardian Prisnamurti ,
  • Tanaya Ghinorawa ,
  • Untung Tranggono ,


Background: Chronic kidney disease (CKD) is a non-communicable disease with high morbidity and mortality. Treatment options for CKD patients are kidney transplantation, hemodialysis, and peritoneal dialysis. Kidney transplantation remains the best option for CKD patients, which has the best Quality of Life compared to other therapies. The cost of therapy for CKD patients is relatively high. Even in developed countries, renal replacement therapy costs are still a burden on the health system and a public health problem. Therefore, this study aims to compare the cost of care for CKD patients undergoing kidney transplantation, hemodialysis, and peritoneal hemodialysis at dr. Sardjito General Hospital, Indonesia.

Methods: This study was a retrospective cohort study of patients who underwent kidney transplantation, continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis from January 2018 to December 2020 at dr. Sardjito General Hospital. We reviewed the medical records, and the data collected was ordinal, numeric, and categorical data. The data was then coded and processed using SPSS version 25.0. The results are presented in descriptive form, tables, or diagrams.

Results: In this study, we found 87 CKD samples. Thirty patients underwent kidney transplantation, 27 patients underwent CAPD, and 30 patients were randomly assigned to undergo routine hemodialysis. Based on the data obtained from this study, the average cost incurred in the first year for patients undergoing kidney transplantation at dr. Sardjito General Hospital amounted to 384.6 million IDR. For CAPD patients, it was 93.7 million IDR, and the average cost for patients undergoing outpatient hemodialysis routinely was 104.1 million IDR. The estimated average cost incurred in the third year after the procedure for kidney transplant patients is 393.7 million IDR, CAPD patients 273.7 million IDR, and patients undergoing routine hemodialysis 307.8 million IDR. The estimated average cost incurred for CKD patients undergoing kidney transplantation was 402.7 million IDR in the fifth year. For CAPD patients was 273.7 million IDR, and for patients undergoing routine hemodialysis was 511.5 million IDR.

Conclusions: The results showed a difference in costs between kidney transplantation, CAPD and hemodialysis. The kidney transplant cost is much more expensive than CAPD and hemodialysis, but the monthly cost is much cheaper than the other two procedures. In the third year estimation, the costs incurred for CAPD and hemodialysis will be close to the costs incurred for kidney transplantation. In the fifth year, the costs for kidney transplantation will be smaller than the costs for CAPD and hemodialysis.


  1. Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709–33.
  2. Liyanage T, Ninomiya T, Jha V. Worldwide Access to Treatment for End-Stage Kidney Disease: A Systematic Review. J Vasc Surg. 2015;62(4):1089. Available from:
  3. Indonesian Nephrologist Association. 8th Report Indonesia Renal Registry [Internet]. Jakarta; 2015. Available from:
  4. YaghoubiFard S, Goudarzi R, Etminan A, Baneshi M, Barouni M, Sirizi MJ. Cost-effectiveness analysis of dialysis and kidney transplant in patients with renal impairment using disability adjusted life years in Iran. Med J Islam Repub Iran. 2016;30:390.
  5. Kementerian Kesehatan. Permenkes No. 52 Thn. 2016 tentang Standar Tarif Pelayanan Kesehatan dalam Penyelenggaraan Program Jaminan Kesehatan. Indonesia; 2016.
  6. Rahn KH, Heidenreich S, Brückner D. How to assess glomerular function and damage in humans. J Hypertens. 1999;17(3):309–17. Available from:
  7. Marbun MBH, Umami V, Susalit E. A 3-year survival rate of kidney transplant recipient in Cipto Mangunkusumo General Hospital in Indonesia. J Ren Med. 2017;1(2):1–5.
  8. Adekoya AO, Halawa A. Kidneys from deceased elderly donors: Factors associated with adverse outcomes. Exp Clin Transpl. 2016;14(1):32–7.
  9. Fatihah AZ, Andayani TM, Yasin NM. The Short Form-6 Dimension (SF-6D) Validity and Reliability in Hemodialysis Patients. J Farm DAN ILMU KEFARMASIAN Indones. 2021;8(2):150–5.
  10. Rosselli D, Rueda J-D, Diaz C. Cost-effectiveness of kidney transplantation compared with chronic dialysis in end-stage renal disease. Saudi J Kidney Dis Transplant. 2015;26(4):733. Available from:
  11. Marbun MBH, Susalit E, Umami V. 7 years experience of living donor kidney transplantation in Indonesia: a retrospective cohort study. Acta Med Indones. 2018;50(2):119–24.
  12. Bircan HY, Kulah E. Effects of a Novel Peritoneal Dialysis: The Open Versus Laparoscopic Preperitoneal Tunneling Technique. Ther Apher Dial. 2015;20(1):66–72. Available from:
  13. Kohar MA, Danarto HR. Survival analysis of continuous ambulatory peritoneal dialysis on patients with end stage renal disease in Sardjito Hospital period 2007-2011. Indones J Urol. 2018;25(2). Available from:
  14. Novelia E, Nugraha RR, Thabrany H. Cost Effectiveness Analysis Between Hemodialysis and Peritoneal Dialysis. J Ekon Kesehat Indones. 2017;1(3). Available from:
  15. Kristinia S, Santoso K. An Estimated Mortality and Disability Adjusted Life Years (DALYs) of Non-communicable Diseases in Indonesia. Int J Pharm Res. 2020;12(sp2):3040–5. Available from:

How to Cite

Prisnamurti, F. H., Ghinorawa, T., & Tranggono, U. (2021). Cost-effectiveness of hemodialysis, peritoneal dialysis and kidney transplantation at dr Sadjito General Hospital in 2018-2020. Indonesia Journal of Biomedical Science, 15(2), 135–139.




Search Panel

Fitra Hardian Prisnamurti
Google Scholar
IJBS Journal

Tanaya Ghinorawa
Google Scholar
IJBS Journal

Untung Tranggono
Google Scholar
IJBS Journal