Objective: To evaluate the cost-utility for Colombia of chronic expanded hemodialysis (HDx), in adults previously treated with conventional chronic high-flow hemodialysis (HD). Method: From an observational clinical study, data are taken from a single mixed cohort of patients. This study was conducted from the perspective of the Colombian health system, with a time horizon of 12 months using HD high-flow chronic hemodialysis and 12 months later, using HDx expanded chronic hemodialysis. To carry out the analysis, the frequency of use and costs of the drugs and the hemodialysis treatment used were considered. Regarding hospitalizations, the hospitalization rate and the days of hospital stay with their associated costs were calculated. In addition, quality of life scores were obtained through the instrument Kidney Disease Quality of Life (KDQOL-36); The conversion of the available data of the quality of life score was carried out through an algorithm that allows the transformation of the global quality of life score to utilities. This algorithm implements the Limited Dependent Variable Adjusted Mixed Models ALDVMMs which is a custom-made model specifically to perform direct mapping of the utility. Results: From the data analyzed of 81 patients, it was obtained that the annualized hospitalization rate slightly decreased from 0.77 to 0.71 with the change from HD to HDx. The days of hospital stay were reduced by 1.5 days after the change (from 5.94 to 4.41 days). There was a decrease in the annualized doses of erythropoietin, iron and aluminum hydroxide medications. The cost of dialysis treatment was similar. In general, a total cost reduction of COP $137,337,821 was evidenced in the cohort. In relation to profits, 12 years of life were gained due to quality of life in all patients. Therefore, HDx is considered a dominant therapy since it decreased costs and increased quality of life. Keywords: Hemodialysis, expanded hemodialysis, costs, quality of life, cost - utility.