Page 26 - GHES-3-2

Global Health Economics and
Sustainability
Retrospective analysis of dialysis and kidney transplant

Table 1. Studies comparing the metrics/variables of interest
Study Study design Population characteristics Evaluated metrics Key findings
Abdi et al. (2022) Cost-benefit Patients in Iran with CKD Cost of transplant; willingness Average cost of transplant: $877.4;
analysis; case to pay; BCR; NPV BCR: 5.39; NPV: $3855; willingness to
study pay significantly affected by income,
insurance, and ESRD duration
Ferhatoğlu et al. Retrospective Kidney transplants in Istanbul Vascular variations; ischemia Mean warm ischemia: 1.82 min; cold
(2019) analysis (n=100); donor mean age: 44.05 years; times (warm and cold); ischemia: 40.25 min; complication: ureter
primary disease: diabetes (36.4%) and post-operation complications; anastomosis stenosis (4.1%); preferred
hypertension (15.6%) anastomosis preference anastomosis: End-to-end (57.2%)
Iqbal et al. (2020) Comparative Transplant patients versus CKD QoL scores: Physical, social, Transplant recipients had the highest
study patients with/without dialysis; QoL energy, and pain QoL scores, some comparable to healthy
assessed across four groups: CKD controls
patients with dialysis, without dialysis,
healthy controls, and transplant
recipients; (age range: 34–49 years)
Abbreviations: CKD: Chronic kidney disease; QoL: Quality of life; ESRD: End-stage renal disease; BCR: Benefit cost ratio; NPV: Net present value.

sources, such as unstructured reports of patient diaries, 9.6. Big data and longitudinal studies
social media, or even clinical notes. These insights provide Big data analytics applied to large-scale QoL datasets
more comprehensive and valuable contributions to can uncover trends and correlations that may influence
understanding QoL (Cohen et al., 2021). health policy decisions and personalized treatment plans

9.3. Personalized and precision medicine (Swan, 2012). Longitudinal QoL tracking improvements
in data collection and analysis will enable long-term QoL
In the future, QoL assessments may be personalized monitoring with remarkable efficiency, facilitating the
to specific patient needs, preferences, and conditions. study of the chronic impact of diseases and their treatments
Questionnaires and adaptive testing techniques could (Swan, 2012).
then be modified based on the information provided by
the patients (Alonso et al., 2004). Genomic and biomarker 10. QoL of patients reported in previous
integration with QoL assessments can also guide studies
personalized treatment according to the characteristics of This review and meta-analysis compared the QoL between
patients to enhance QoL (Alonso et al., 2004).
kidney transplant recipients and dialysis patients from
9.4. Holistic and multidimensional assessment various studies. The results are summarized in Table 1,
aligning with our inference; transplant recipients
Future QoL assessments could include additional QoL consistently experienced a better QoL across various areas,
dimensions, expanding QoL tools beyond indicators such as physical functioning, emotional well-being, and
of physical and mental health to encompass social social interactions (Iqbal et al., 2020).
determinants of health, environmental factors, and
spiritual well-being (Mihalopoulos et al., 2022). The 11. Conclusion
incorporation of patient-generated health data within In comparison with dialysis, kidney transplantation offers
QoL measurements would enable a complete and more clinical advantages in QoL and is more cost-effective
comprehensive description of the patient’s life, accounting for patients with ESRD. Transplant patients experience
for daily activities, stress factors, and social interactions significantly better QoL, including improvements in
(Mihalopoulos et al., 2022). physical and emotional well-being, independence, and

9.5. Telemedicine and remote monitoring overall life satisfaction, compared to dialysis patients. The
nature of dialysis treatment, especially HD, is complicated
Telemedicine can be used for remote QoL assessments, and taxing, which naturally leads to a lower QoL. Although
enabling more frequent and consistent evaluations, particularly kidney transplantation incurs higher initial expenses,
for rural or underserved patients. Remote monitoring of it is more economical over time due to reduced ongoing
symptoms and side effects through telemedicine allows for medical expenses and improved QoL. Conversely, dialysis,
real-time adjustments of the treatment plan, optimizing particularly in-center HD, incurs higher long-term
patient QoL (Kaufman et al., 2019). expenditures due to its ongoing requirement for treatment.

Volume 3 Issue 2 (2025) 18 https://doi.org/10.36922/ghes.4639