Economic Analysis of the Treatment of End-stage Renal Disease Treatment: Living-donor Kidney Transplantation Versus Hemodialysis

Sánchez-Escuredo, Ana; Alsina, Ángel; Diekmann, Fritz; Revuelta, Ignacio; Esforzado, Núria; Ricart, M.J.; Cofan, Frederic; Torregrosa, José-Vicente; Campistol, Josep M.; Oppenheimer, Federico; Fernandez, E.

doi:10.1016/j.transproceed.2014.12.005

Cited by 40 publications

(24 citation statements)

References 10 publications

(9 reference statements)

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“…Overall, the study concluded that live donor kidney transplantation is more cost-effective than hemodialysis, representing a savings of 13,102.97 per patient/y. The study further reported two findings; a. the costs of kidney transplantation shrink after year one, while the costs of hemodialysis remain the same, b. kidney transplantation is associated with higher quality of life (QALY) than hemodialysis treatment, although the study did not report any numerical values associated with QALY [9].…”

Section: Comparative Cost-effectiveness Of Esrd Treatment Optionsmentioning

confidence: 96%

Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia

Tataradze¹,

Managadze²,

Beglarashvili³

et al. 2016

IJCM

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End-Stage Renal Disease (ESRD) represents one of the most challenging social and medical problems mainly due to substantial treatment-associated costs. The chronic nature of the disease needs expensive continuous care that majority of the patients cannot afford. Therefore, in many countries expenses associated with the ESRD treatment is paid by state government. These treatment options include: hemodialysis, peritoneal dialysis and kidney transplantation. Multiple studies have been conducted throughout the world to assess cost-effectiveness of these treatment modalities. The studies suggest that kidney transplantation not only reduces mortality and morbidity but improves a quality of life of ESRD patients. Furthermore, it is the most cost-effective treatment for the ESRD at least in high-income countries. The goal of our study was to determine whether above-mentioned is true for lower middle income countries, where the cost of the ESRD treatment is substantially lower. Despite the low dialysis costs, transplantation remains the cheapest form of renal replacement therapy RRT in lower income countries like Georgia. Our results reveal, that kidney transplantation is most expensive modality of Renal Replacement Therapy (RRT) at month 1, but count of costs reveals that after the 10 th month of treatment, the cumulative cost of transplantation is less than the cumulative cost of peritoneal dialysis and after the 23 rd month, cumulative cost of hemodialysis also surpasses the cumulative cost of transplantationrelated treatment and this cost comparison is in line with global data from upper-middle and high income countries. A. Tataradze et al. 438

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Section: Comparative Cost-effectiveness Of Esrd Treatment Optionsmentioning

confidence: 96%

Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia

Tataradze¹,

Managadze²,

Beglarashvili³

et al. 2016

IJCM

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“…, Sanchez‐Escuredo et al . ). However, as KTx demands significantly exceed graft availability, fair allocation demands risk prediction models that predict both personal and societal costs.…”

Section: Introductionmentioning

confidence: 97%

“…, Sanchez‐Escuredo et al . ). As frailty is a long‐term condition with adverse patient and healthcare system outcomes, frail, and pre‐frail older non‐institutionalized patients use more healthcare resources than their non‐frail counterparts (Sirven & Rapp , Harrison et al .…”

Section: Introductionmentioning

confidence: 97%

“…Frailty and MCI in KTx: the need for a health economic perspective While dialysis and KTx are both extremely costly, KTx is clearly more cost-effective (Ferguson et al 2015, Sanchez-Escuredo et al 2015. However, as KTx demands significantly exceed graft availability, fair allocation demands risk prediction models that predict both personal and societal costs.…”

Section: Introductionmentioning

confidence: 99%

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ExplorinG frailty and mild cognitive impairmEnt in kidney tRansplantation to predict biomedicAl, psychosocial and health cost outcomeS (GERAS): protocol of a nationwide prospective cohort study

Mauthner

Claes

Walston

et al. 2016

Journal of Advanced Nursing

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Aim To present the rationale, design and methodology of the GERAS project, which examines whether assessment of frailty and mild cognitive impairment could enhance risk prediction for biomedical, psychosocial outcomes and foster efficient resource allocation in kidney transplantation. Background For the burgeoning cohort of older patients considered for kidney transplantation, evidence gaps regarding frailty and mild cognitive impairment limit clinical decision‐making and medical management. As known risk factors for ‘hard’ clinical outcomes in chronic illness, both require further study in transplantation. Integrating these and other bio‐psychosocial factors into a comprehensive pre‐transplant patient assessment will provide insights regarding economic implications and may improve risk prediction. Design A nation‐wide multi‐centre prospective cohort study nested in the Swiss Transplant Cohort Study. Methods Our nationally representative convenience sample includes 250 adult kidney transplant recipients. Data sources include the Swiss Transplant Cohort Study and primary data collected at time of transplantation, 6 months, 1 and 2 years post‐transplant via established measures (the Montreal Cognitive Assessment, Psychosocial Questionnaire, Fried Frailty Instrument and a blood analysis), investigator‐developed instruments and datasets compiled by hospitals’ management control units, sickness funds, the Swiss Federal Statistical Office and the European Renal Association. Descriptive, competing risk survival and mixed effects analyses will be performed. Research Ethics Committee approval was obtained in January 2016. Discussion This pioneering project jointly examines frailty and mild cognitive impairment from bio‐psychosocial and health economic perspectives. Results may significantly inform risk prediction, care tailoring and resource optimization to improve health outcomes in the ageing kidney transplant cohort.

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“…Although kidney transplantation involves a large initial expense, over time it is the most cost effective form of RRT [5][6][7] and is also associated with an increased quality of life and reduced morbidity and mortality compared to patients who remain on the waiting list [4] . However, the waiting lists are steadily increasing as demand for organs grows higher than the supply [2] .…”

mentioning

confidence: 99%

Disparities in Kidney Transplantation Access among Korean Patients Initiating Dialysis: A Population-Based Cohort Study Using National Health Insurance Data (2003-2013)

et al. 2016

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Background: The socioeconomic status of a person has an impact on his or her access to kidney transplantation as has been reported in western countries. This study examined the association between income level and kidney transplantation among chronic kidney disease patients undergoing dialysis in South Korea. Methods: We analyzed data from 1,792 chronic kidney disease patients undergoing dialysis and listed in the Korean National Health Insurance Claim Database (2003-2013). The likelihood of receiving the first kidney transplant over time was analyzed using competing risk proportional hazard models on time from initiating dialysis to receiving a transplant. Results: Of 1,792 patients on dialysis, only 184 patients (10.3%) received kidney transplants. Patients with medical aid had the lowest kidney transplantation rate (hazard ratio 0.29, 95% CI 0.16-0.51). A lower income level was significantly associated with a low kidney transplantation rate, after adjusting for covariates, compared to patients in the high-income level group. Conclusions: Our findings indicate that in South Korea, the total number of kidney transplants is remarkably low and there exists income disparity with regard to access to kidney transplantation. Thus, we suggest that plans be implemented to encourage organ donation and increase organ transplant accessibility for all patients irrespective of their socioeconomic status.

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Economic Analysis of the Treatment of End-stage Renal Disease Treatment: Living-donor Kidney Transplantation Versus Hemodialysis

Cited by 40 publications

References 10 publications

Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia

Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia

ExplorinG frailty and mild cognitive impairmEnt in kidney tRansplantation to predict biomedicAl, psychosocial and health cost outcomeS (GERAS): protocol of a nationwide prospective cohort study

Disparities in Kidney Transplantation Access among Korean Patients Initiating Dialysis: A Population-Based Cohort Study Using National Health Insurance Data (2003-2013)

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