AccScience Publishing / GHES / Online First / DOI: 10.36922/ghes.4639
REVIEW ARTICLE

A cross-sectional comparative analysis of quality of life and cost-effectiveness for retrospective dialysis and kidney transplant patients

Mohammad Akil Shaikh1 Yogesh Raval1 Ghadir Mohemmad1 Kushal Parekh1 Kiran Dudhat1*
Show Less
1 Department of Pharmacology, School of Pharmacy, RK University, Rajkot, Gujarat, India
Submitted: 23 August 2024 | Revised: 11 October 2024 | Accepted: 1 November 2024 | Published: 28 February 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Dialysis, including hemodialysis (HD) and peritoneal dialysis, is initiated when kidney function deteriorates to a glomerular filtration rate below the normal range. In addition, dialysis manages renal failure through diffusion and ultrafiltration but does not completely replace kidney function. Conversely, kidney transplantation involves replacing a diseased kidney with a healthy donor kidney, offering restored kidney function and improved quality of life (QoL). Herein, this review compares the QoL and cost-effectiveness of dialysis versus kidney transplantation for patients with end-stage renal disease (ESRD). Transplant recipients generally report better physical and mental well-being, higher independence, and greater overall life satisfaction compared to dialysis patients. Economically, kidney transplantation, despite its high initial costs, proves more cost-effective in the long run due to reduced ongoing healthcare expenses. Dialysis, particularly in-center HD, incurs higher long-term costs. The findings advocate prioritizing kidney transplantation for eligible ESRD patients while also emphasizing the need for improved support for dialysis patients.

Keywords
Quality of life
Cost-effectiveness
Kidney transplant
Dialysis
End-stage renal disease
Funding
None.
Conflict of interest
The authors declare no conflicts of interest.
References

Cohen, A., Ioannidis, K., Ehrlich, A., Regenbaum, S., Cohen, M., Ayyash, M., et al. (2021). Mechanism and reversal of drug-induced nephrotoxicity on a chip. Journal of Translational Medicine, 13:eabd6299. https://doi.org/10.1126/scitranslmed.abd6299

 

Abdi, F., Alinia, C., Taghizadeh Afshari, A., & Yusefzadeh, H. (2022). Cost-benefit analysis of kidney transplant in patients with chronic kidney disease: A case study in Iran. Cost Effectiveness and Resource Allocation, 20:37. https://doi.org/10.1186/s12962-022-00372-1

 

Abramyan, S., & Hanlon, M. (2024). Kidney transplantation. In: StatPearls. Treasure Island, FL: StatPearls Publishing.

 

Alonso, J., Ferrer, M., & Gandek, B. (2004). Health-related quality of life measurement in clinical practice: A critical review of patient-reported outcome measures. Value in Health, 7(1):17-28. https://doi.org/10.1023/B: QURE.0000015298.09085.b0

 

Alscher, D.M. (2005). Principles of peritoneal dialysis. EDTNA‐ERCA Journal, 31(3):124-129. https://doi.org/10.1111/j.1755-6686.2005.tb00410.x

 

Amerling, R., Glezerman, I., Savmnsky, E., Dubrow, A., & Ronco, C. (2003). Continuous flow peritoneal dialysis: Current perspectives. Contributions to Nephrology, 140:294-304. https://doi.org/10.1159/000071402

 

Au, E., Wong, G., & Chapman, J.R. (2018). Cancer in kidney transplant recipients. Nature Reviews Nephrology, 14(8):508-520. https://doi.org/10.1038/s41581-018-0022-6

 

Dasdelen, S., & Grebe, S. Infections after renal transplantation. LaboratoriumsMedizin, 41(S1):20170094. https://doi.org/10.1515/labmed-2017-0094

 

Ferhatoğlu, M.F., Kartal, A., Kıvılcım, T., Filiz, A.İ., Kebudi, A., & Gürkan, A. (2019). Retrospective analysis of the first 100 kidney transplants at the Istanbul Okan University, Health Application and Research Center. Medical Bulletin of Sisli Etfal Hospital, 53(3):221-227. https://doi.org/10.14744/SEMB.2019.54533

 

Gabolde, M., Hervé, C., & Moulin, A.M. (2001). Evaluation, selection, and follow-up of live kidney donors: A review of current practice in French renal transplant centres. Nephrology Dialysis Transplantation, 16(10):2048-2052. https://doi.org/10.1093/ndt/16.10.2048

 

Gordon, E.J., & Sehgal, A.R. (2000). Patient-nephrologist discussion about kidney transplantation as a treatment option. American Journal of Kidney Diseases, 36(1):140-149. https://doi.org/10.1053/rr.2000.5268

 

Hays, R.D., & McClellan, W.M. (2018). Economic considerations in the management of chronic kidney disease. American Journal of Kidney Diseases, 71(5):737-745.

 

Iqbal, M.M., Rahman, N., Alam, M., Nath, P.K., Waheed, S., Islam, K., et al. (2020). Quality of life is improved in renal transplant recipients versus that shown in patients with chronic kidney disease with or without dialysis. Experimental and Clinical Transplantation: Official Journal of the Middle East Society for Organ Transplantation, 18(Suppl 1):64-67. https://doi.org/10.6002/ect.TOND-TDTD2019.P11

 

Kaufman, D., Roberts, W.C., & Roan, C.L. (2019). The future of telemedicine in measuring patient quality of life: Opportunities and challenges. Telemedicine and e-Health, 25(10):898-905. https://doi.org/10.1258/135763307783064340

 

Kiberd, B.A., Keown, P. (2014). Cost-effectiveness of kidney transplantation versus dialysis: A review of the literature. American Journal of Kidney Diseases, 64(4):513-523.

 

Kumar, S., & Sharma, A. (2020). Equity in kidney transplantation: Current challenges and future directions. Transplantation Proceedings, 52(5):1437-1442.

 

Liyanage, T., Toyama, T., Hockham, C., Ninomiya, T., Perkovic, V., Woodward, M., et al. (2022). Prevalence of chronic kidney disease in Asia: A systematic review and analysis. BMJ Global Health, 7(1):e007525. https://doi.org/10.1136/bmjgh-2021-007525

 

Maglakelidze, N., Pantsulaia, T., Tchokhonelidze, I., Managadze, L., & Chkhotua, A. (2011). Assessment of health-related quality of life in renal transplant recipients and dialysis patients. Transplantation Proceedings, 43(1):376-379. https://doi.org/10.1016/j.transproceed.2010.12.015

 

Marroquin, C.E. (2019). Patient selection for kidney transplant. Surgical Clinics, 99(1):1-35. https://doi.org/10.1016/j.suc.2018.09.002

 

Mehrotra, R., Devuyst, O., Davies, S.J., & Johnson, D.W. (2016). The current state of peritoneal dialysis. Journal of the American Society of Nephrology, 27(11):3238-3252. https://doi.org/10.1681/ASN.2016010112

 

Mihalopoulos, M., Yaghoubian, A., Razdan, S., Khusid, J.A., Mehrazin, R., Badani, K.K., et al. (2022). Understanding the link between kidney stones and cancers of the upper urinary tract and bladder. American Journal of Clinical and Experimental Urology, 10(5):277-298.

 

Miller, R.R., & McLachlan, C. (2016). The role of quality of life and cost-effectiveness analyses in healthcare decision-making for kidney failure treatment. Health Policy, 120(2):163-172.

 

Murdeshwar, H.N., & Anjum, F. (2020). Hemodialysis. In: StatPearls. Treasure Island, FL: StatPearls Publishing.

 

Olsson, R., & Helgesson, J. (2019). Economic evaluation of kidney transplantation: A systematic review. Journal of Health Economics, 65:123-135. https://doi.org/10.1097/TP.0000000000000079

 

Parker, T.S., & Molzahn, A.E. (2017). Comparing quality of life in dialysis and kidney transplant patients: A systematic review and meta-analysis. Journal of Nephrology, 30(6):715-726.

 

Raimann, J.G., & Kuhlmann, M.K. (2016). Cost-effectiveness of renal replacement therapies: A review. Nephrology Dialysis Transplantation, 31(10):1611-1622. https://doi.org/10.1093/ndt/gfq780

 

Rosselli, D., Rueda, J.D., & Diaz, C.E. (2015). Cost-effectiveness of kidney transplantation compared with chronic dialysis in end-stage renal disease. Saudi Journal of Kidney Diseases and Transplantation, 26(4):733-738. https://doi.org/10.4103/1319-2442.160175

 

Santosh, R., Mohammed, Y.N., Rahaman, Z., & Khurana, S. (2024). The role of telemedicine in enhancing chronic kidney disease (CKD) management and dialysis care. Cureus, 16(3):e55816. https://doi.org/10.7759/cureus.55816

 

Sarhan, A.L., Jarareh, R.H., & Shraim, M. (2021). Quality of life for kidney transplant recipients and hemodialysis patients in Palestine: A cross-sectional study. BMC Nephrology, 22:210. https://doi.org/10.1186/s12882-021-02412-z

 

Shtepa, O., Kuryata, O., & Halushchak, O. (2022). Impact of the duration of program hemodialysis and heart failure on the pattern of lipid profile in patients with end-stage chronic kidney disease. Atherosclerosis Journal, 355:203C. https://doi.org/10.3390/healthcare5030052

 

Stachowska-Pietka, J., Waniewski, J., & Lindholm, B. (2015). Peritoneal dialysis: Principles and peritoneal physiology. In: Oxford Textbook of Clinical Nephrology. United Kingdom: Oxford University Press, p.2260-2273.

 

Swan, M. (2012). The quantified self: Fundamental disruption in big data science and biological discovery. Big Data, 1(2):85-99. https://doi.org/10.1089/big.2012.0002

 

Tepel, M., Alkaff, F.F., Kremer, D., Bakker, S.J., Thaunat, O., Nagarajah, S., et al. (2022a). Pretransplant endotrophin predicts delayed graft function after kidney transplantation. Scientific reports, 12(1):4079. https://doi.org/10.1038/s41598-022-07645-y

 

Tepel, M., Nagarajah, S., Saleh, Q., Thaunat, O., Bakker, S.J., van den Born, J., et al. (2022b). Pretransplant characteristics of kidney transplant recipients that predict posttransplant outcome. Frontiers in Immunology, 13:945288. https://doi.org/10.3389/fimmu.2022.945288

 

Tonelli M, Wiebe N, Knoll G, Bello A, Browne S, Jadhav D, et al. Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes. Am J Transplant 2011;11:2093-109. https://doi.org/10.1111/j.1600-6143.2011.03686.x

 

Van Mil, D., Pouwels, X.G., Heerspink, H.J., & Gansevoort, R.T. (2024). Cost-effectiveness of screening for chronic kidney disease: Existing evidence and knowledge gaps. Clinical Kidney Journal, 17(1):sfad254. https://doi.org/10.1093/ckj/sfad254

 

Wang, J.H., Skeans, M.A., & Israni, A.K. (2016). Current status of kidney transplant outcomes: Dying to survive. Advances in Chronic Kidney Disease, 23(5):281-286. https://doi.org/10.1053/j.ackd.2016.07.001

 

Ye, H., Ding, H., Gan, W., Wen, P., Zhou, Y., Cao, H., et al. (2020). Hemodialysis. In: Chronic Kidney Disease: Diagnosis and Treatment. Germany: Springer, p.209-231. https://doi.org/10.52403/ijhsr.20230227

 

Share
Back to top
Global Health Economics and Sustainability, Electronic ISSN: 2972-4570 Print ISSN: 3060-8546, Published by AccScience Publishing