Kidney transplantation versus dialysis in Zimbabwe: a systematic review of the cost-effectiveness

In Zimbabwe, the population of patients with chronic kidney disease is rising, putting a strain on the nation’s few dialysis treatment centers, whether government or private. The government covers the whole expense of delivering dialysis in the government facilities, increasing the financial burden. Patients from both public and private dialysis units opting for kidney transplantation (KT) are referred abroad at high foreign currency costs. The goal of this study focused on reviewing the economic advantage of KT in relation to renal dialysis as a means of establishing a KT program in Zimbabwe. Economic advantage studies on KT versus renal dialysis were obtained using various digital resources. The search strategy was based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses recommendations. Economic assessment tools such as the Markov model, cost–utility analysis, cost-effective analysis were utilized to substantiate the relevance of KT in improving survival of end-stage renal disease patients at a lower expenditure. In studies where cost-effectiveness between KT and dialysis was compared, it was shown that KT is a cheaper solution with a higher quality of life than dialysis. It was also shown in most of the studies that among the dialysis modalities, hemodialysis (HD) was more expensive than peritoneal dialysis (PD). In one of the studies, the cost values were Euro 36 000 for HD, Euro 26 000 for PD, and Euro 11 000 for KT. The quality-adjusted life years per patient were 0.46 for HD, 0.49 for PD, and 0.61 for KT. As far as cost-effectiveness and raising the health status, wellness level, good living, and survival, KT is rated highly and a better modality than dialysis. It is a more appropriate renal treatment for introduction in Zimbabwe to save on the scarce foreign currency. The barriers to the commencement of KT were identified, and the solutions were enumerated.