Abstract
BACKGROUND: Increasing healthcare spending is a significant issue, with the aging population contributing to a rise in patients needing renal replacement therapy. The cost of peritoneal dialysis (PD) is substantial, particularly in upper-middle-income countries like Serbia. We aimed to identify the direct costs and influencing factors of treating peritoneal dialysis-associated peritonitis (PD associate peritonitis) in Serbia. METHODS: A retrospective observational study was conducted on consecutive patients admitted due to PD-associated peritonitis in five tertiary care hospitals across Serbia in 2019-2022. The primary outcome was total cost of hospitalization. Potential predictors were determined using generalized linear model with a gamma probability distribution and a log link function. RESULTS: The study included 122 patients. The average total cost per patient was 1131.90±1538.67 USD, with the cost of hospitalization (348.17 ± 361.52 USD) and antibiotics (294.94±465.88 USD) being the most significant. The length of hospitalization (P<0.001) and treatment outcome (P<0.001) were found to be significant predictors of the total cost. CONCLUSION: The costs of treating PD associate peritonitis in Serbia are substantial, with each additional day of hospitalization significantly increasing the cost. The importance of patient and doctor education about infection prevention is underscored by the health consequences and the lengthy, expensive treatment when an infection occurs.