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[Financial impact of anemia in patients with chronic renal insufficiency undergoing hemodialysis at centers].

The aim of this study was to evaluate the financial impact of anemia and transfusions in patients undergoing hemodialysis. Among a total population of 309 patients treated in 6 French hemodialysis centers, 30 have been selected to enter in a detailed evaluation: 15 (Group 2) having received in 1987 eight blood units or more, and 15 (Group 1) not transfused during the period of study. The expenditures were calculated for both groups in each category, excluding the direct cost of dialysis sessions. The analysis shows that transfused patients cost roughly 28542 FF more per capita and per year than nontransfused patients. The most important causes of increasing expenditure were not only the cost of blood units (10140 FF per patient and per year), but also direct and indirect costs of medical and biologic follow-up of transfused dialysis patients, such as outpatient visits, surgery and hospitalizations (19061 FF per capita and per year). A major center effect was evidenced, the center variation being influenced by the variation in inpatient enrollment, and variation in medical policies. Since the cost of the end-stage renal failure would be strongly affected by the costly addition of human recombinant erythropoietin to the therapeutic armamentorium, it would be advisable to take into account in economic outcomes for dialysis patients savings through reduced need for blood transfusions and perhaps fewer hospitalizations.