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| Year : 2009 | Volume
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| Issue : 4 | Page : 675-676 |
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| Cost of hemodialysis in Iran |
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Mitra Mahdavi-Mazdeh
Tehran University of Medical Sciences, Director of Transplantation Research Center& Iranian Tissue Bank, Tehran, Iran
Click here for correspondence address and email
| Date of Web Publication | 8-Jul-2009 |
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How to cite this article:
Mahdavi-Mazdeh M. Cost of hemodialysis in Iran. Saudi J Kidney Dis Transpl 2009;20:675-6 |
To the Editor,
This is with reference to the article published in your esteemed journal, issue dated 2009;20 (2):307-311 entitled: "The Cost of Hemodialysis in Iran". The authors have published this article to report on the cost of hemodialysis (HD) in Iran in an appropriate international nephrology journal. However, there are some problems with this paper.
It has been tried, through some recent publications, to publicize and convince decision makers in Iran, to change their approach towards patients on maintenance HD as well as its impact on national resources. In Iran, data from all centers which have facilities for renal replacement therapy (RRT) are updated every three months in a central database, the Management Center for Transplantation and Special Diseases (MCTSD), affiliated to the Ministry of Health (MOH). [1],[2]
The main issues I wish to highlight regarding the paper published earlier are:
- The authors have translated costs into US dollars, but have not specified the reference year for currency conversion. Even the comparisons made with other international centers do not carry the reference year for USD conversion, thus making meaningful interpretation difficult and impractical.
- Itemized description of expenses have not been made properly. The cost of HD in both public and private hospitals in Iran is borne by the government through insurance organizations; the reimbursement rate is fixed and is only for providing dialysis and drugs. The remaining amount is paid by the MOH (for dialyzers and other related supplies). [1] ,[3] ,[4] It seems that the authors did not calculate the subsidy paid by government.
- Health care sector costs associated with each HD session were estimated at US$ 78.87. [2] The reported average cost of one dialysis session, without including the cost of human resources and drugs is USD 43.20. [4] Most of the expenditure was towards medical supplies (36.19%), with dialyzers contributing most to the cost. Staff salaries represented 17% of the cost and fixed direct capital costs accounted for 21.4%. [3]
- The title of the article suggests that the authors are discussing the cost of HD in Iran as a whole; however, the data are from a single center in Tehran; there are more than 305 HD centers in Iran. [2] . Although we agree that many treatment services may be similar, issues related to transportation and absence from work are significantly different in different centers.
Additionally, in-center HD patients receive, on an average, 4-hour treatments, three times per week. However, between nine and 40% of dialysis patients receive less frequent HD sessions, an issue that has not been highlighted by the authors. [2] ,[4]
 References | |  |
| 1. | Mahdavi-Mazdeh M, Heidary Rouchi A, Norouzi S, Aghighi M, Rajolani H, Ahrabi S. Renal replacement therapy in Iran. Urol J 2007;4(2): 66-70  |
| 2. | Aghighi M, Heidary Rouchi A, Zamyadi M, et al. Dialysis in Iran. Iran J Kidney Dis 2008; 2(1):11-5. |
| 3. | Mahdavi-Mazdeh M, Zamani M, Zamyadi M, et al. Hemodialysis cost in Tehran Iran. Hemodial Int 2008;12(4):492-8. |
| 4. | Mahdavi-Mazdeh M, Zamyadi M, Nafar M. Assessment of management and treatment responses in haemodialysis patients from Tehran province, Iran. Nephrol Dial Transplant 2008; 23(1):288-93. |
Correspondence Address:
Mitra Mahdavi-Mazdeh
Tehran University of Medical Sciences, Director of Transplantation Research Center& Iranian Tissue Bank, Tehran
Iran
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PMID: 19587519 
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