终末期肾病（ESKD）与相当大的经济负担有关。在法国，此类患者的护理费用占据了总法国医疗保健支出的2.5％，但仅服务少于1％的人口。由于需要专业和复杂的治疗以及多种共患症的存在，这些患者的医疗支出很高。本研究旨在描述和评估共患症对肾功能衰竭患者在法国的医疗支出（包括直接医疗费用和非医疗费用，如交通费和补贴津贴）的影响，同时考虑肾脏替代治疗（RRT）的方式和持续时间。本研究包括在2012年至2014年之间首次开始RRT治疗的成年人，并进行了为期5年的随访。建立广义线性模型来预测平均每月费用（MMC），首先整合队列中的时间持续时间，然后是患者特征，最后是每种治疗方式的使用时间。对MMC影响最大的共病包括不能行走（+ 1435€）、活动性癌症（+ 593€）、HIV阳性（+ 507€）和糖尿病（+ 396€）。这些影响因年龄或治疗方式而异。本研究证实了在评估肾病患者的医疗支出时考虑患者特征，共患症和RRT类型的重要性。©2023.作者（s），在Springer-Verlag GmbH Germany的独家许可下，属于Springer Nature的一部分。

End-stage kidney disease (ESKD) is associated with a substantial economic burden. In France, the cost of care for such patients represents 2.5% of the total French healthcare expenditures but serves less than 1% of the population. These patients' healthcare expenditures are high because of the specialized and complex treatment needed as well as the presence of multiple comorbidities. This study aims to describe and assess the effect of comorbidities on healthcare expenditures (direct medical cost and non-medical costs including transportation and compensatory allowances) for patients with ESKD in France while considering the modality and duration of renal replacement therapy (RRT). This study included adults who started RRT for the first time between 2012 and 2014 in France and were followed for 5 years. Generalized linear models were built to predict mean monthly cost (MMC) by integrating first the time duration in the cohort, then patient characteristics and finally the duration of use of each treatment modalities. Comorbidities with the highest effect on MMC were inability to walk (+ 1435€), active cancer (+ 593€), HIV positivity (+ 507€) and diabetes (+ 396€). These effects vary according to age or treatment modalities. This study confirms the importance of considering patient characteristics, comorbidities and type of RRT when assessing healthcare expenditures for patients with ESKD.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.