Perbandingan Biaya Global Hemodialisis dan Dialisis Peritonal Pada Penyakit Ginjal Tahap Akhir: Tinjauan Sistematis Berdasarkan Tingkat Pendapatan Negara
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Meningkatnya prevalensi penyakit ginjal stadium akhir menimbulkan tantangan ekonomi bagi sistem perawatan kesehatan di seluruh dunia. Hemodialisis dan dialisis peritoneal saat ini merupakan modalitas terapi pengganti ginjal yang paling umum digunakan, tetapi biayanya bervariasi berdasarkan komponen dan konteks ekonomi. Tinjauan sistematis ini bertujuan untuk membandingkan biaya hemodialisis dan dialisis peritoneal di berbagai negara berdasarkan tingkat pendapatan dan perspektif ekonomi. Pencarian literatur sistematis dilakukan menggunakan basis data EBSCO, ProQuest, PubMed, Scopus, dan SpringerLink, dengan studi yang dilakukan pada tahun 2015–2025. Studi yang melaporkan analisis biaya hemodialisis dan/atau dialisis peritoneal disertakan. Proses seleksi menggunakan pedoman PRISMA dan metodologi dinilai berdasarkan CHEERS 2022. Sebanyak 33 studi disertakan untuk dibahas berdasarkan tingkat pendapatan dari rendah hingga tinggi. Secara ekonomi, dialisis peritoneal ditemukan lebih hemat biaya daripada hemodialisis dalam sebagian besar studi. Perbedaan dalam struktur biaya disebabkan oleh biaya medis langsung, yang merupakan komponen biaya terbesar. Pengobatan hemodialisis lebih mahal karena ketersediaan mesin dialisis, fasilitas layanan, tenaga kerja, dan biaya infrastruktur, serta hilangnya produktivitas akibat biaya medis tidak langsung. Keuntungan dialisis peritoneal meliputi biaya transportasi yang lebih rendah, pengurangan kehilangan produktivitas, dan aksesibilitas di negara-negara berpenghasilan rendah dan menengah. Beberapa penelitian juga menunjukkan bahwa dialisis peritoneal menghasilkan tahun hidup yang disesuaikan dengan kualitas (QALY) yang sebanding dengan hemodialisis. Kesimpulan dari tinjauan sistematis ini adalah bahwa dialisis peritoneal dapat hemat biaya di sebagian besar negara berpenghasilan tinggi dan harus dipertimbangkan sebagai modalitas pengobatan pilihan untuk meningkatkan efisiensi, mengendalikan biaya jangka panjang dalam terapi ginjal, serta mendukung pengelolaan asuransi kesehatan
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