Dialysis-Related Medical Expenditures of Hemodialysis and Peritoneal Dialysis in Japan

Introduction: Although the high cost of dialysis therapy can be an economic burden, peritoneal dialysis (PD) accounts for approximately 3% of the dialysis population. Studies comparing medical costs of PD and hemodialysis (HD) in Japan are limited. We investigated medical expenditures of PD and HD using the National Database (NDB) Open Data to clarify the current status of dialysis modality-specific medical expenditures in Japan. Methods: This was a descriptive analysis of aggregate data from the NDB Open Data for fiscal years 2014 to 2024 (April 2014 to March 2025). Dialysis-related items were extracted from the dataset. In this study, medical expenditures related to PD and HD were aggregated. Results: Total dialysis therapy expenditures showed an increasing trend from 1,057,950 million JPY in fiscal year 2014 to 1,209,499 million JPY in fiscal year 2019. Although a slight decline was observed thereafter, total expenditures reached 1,272,637 million JPY in fiscal year 2024. PD-related medical expenditures consistently accounted for approximately 2% of total dialysis therapy expenditures throughout the study period; HD-related expenditures comprised the majority. Conclusions: This study found that total dialysis therapy expenditures in Japan reached approximately 1.273 trillion JPY in fiscal year 2024, with HD-related medical expenditures accounting for the majority.