| Summary: | During the last ten years, the number of dialysis patients has doubled in Norway. After a request from The Norwegian Directorate of Health we performed a Health Technology Assessment comparing efficacy, safety and cost-effectiveness of the different dialysis modalities 1) Hemodialysis carried out in hospital, 2) self-care hemodialysis in hospital, 3) hemodialysis in satellite unit (nursing home, local medical centre), 4) hemodialysis at home and 5) peritoneal dialysis at home for patients with end-stage renal failure requiring dialysis in Norway. Our outcomes were mortality, complications that require special measures and quality of life. Clinical findings Of 21 possible comparisons only six had published data. For the comparisons with published data and low quality of the evidence, we found:1. no significant differences in mortality, in quality of life or in infections2. significantly fewer hospitalisation days per patients per year in the hemodialysis hospital group versus the peritoneal dialysis at home group Economic evaluation 1. In our model analyses all dialysis modalities were almost equally effective. 2. Hemodialysis at home was the most effective and cost-effective alternative compared to all other hemodialysis modalities from both healthcare and societal perspectives. 3. Peritoneal dialysis was the least costly, and hence the most cost-effective alternative compared to all hemodialysis modalities. 4. The results of our sensitivity analysis showed that cost data had the greatest impact on the results' uncertainty
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