Financial burden of chronic kidney disease patients on maintenance hemodialysis in Chittagong, Bangladesh

Abstract

Background: Chronic kidney disease (CKD) is an important public health problem. Renal replacement therapy is needed for patients who go to end-stage renal disease. Most of the evidence on its costs relates to patients receiving dialysis or kidney transplants, which shows that, in these phases, CKD poses a high burden to payers. The aim of this study was to estimate the financial burden of patients with CKD on maintenance hemodialysis. Methods: It is a 1-year observational study, carried out to collect data on 105 patients with CKD on dialysis taken from different centers in Chittagong, Bangladesh. After the collection of sociodemographic information, financial status was collected from patients who gave informed written consent to be included in the study. Data were analyzed using SPSS 20. Results: Regarding gender distribution, male was 73 (69.5%) and female was 32 (30.5%). The male-to-female ratio was 2.28:1. Age group distribution revealed 10 (9.5%) patients were at <30 years, 18 (17.1%) were at 31–40 years, 23 (21.9%) were at 41–50 years, 26 (24.8%) were at 51–60 years, 20 (19.0%) were at 61–70 years, and 8 (7.6%) were >71 years age. Among all most were involved in service 40 (38.1%) and business 23 (21.9%). The socioeconomic status of the patients revealed that 42 (40.0%) patients were from the upper-middle-class, and 50 (47.6%) were from the lower-middle-class. Among all, 33 (31.4%) patients took treatment from abroad. Regarding bearing of cost of the dialysis, 24 (22.9%) were self-financed, 35 (33.3%) got help from others (nonfamily members), 11 (10.5%) took loan, and 13 (12.4%) sold their stable land property. Regarding tenure of dialysis, 31 (29.5%) patients are getting dialysis <1 year and 74 (70.5%) were getting it for 1–2 years. Previous monthly income before the start of dialysis was zero in 33 (31.4%) patients and it was >30,000 taka/month in 34 (32.4%) patients and after the start of dialysis, present monthly income was zero per month in 67 (63.8%) patients and >30,000 taka/month in 13 (12.4%) patients. Regarding expenditure for each dialysis showed 2 (1.9%) had zero taka and 46 (43.8%) patients needed 1000–2000 taka/session and 41 (39.0%) needed 2000–3000 taka/session. Conclusion: Dialysis in CKD patients is a huge financial burden to the patients themselves and their families. Government assistance should be provided to all patients who are unable to bear the cost.