Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Dec;21(12):859-877.
doi: 10.1038/s41581-025-01000-w. Epub 2025 Sep 11.

Guidelines for the use of economic evaluation to inform policies around access to treatment for kidney failure

Affiliations
Review

Guidelines for the use of economic evaluation to inform policies around access to treatment for kidney failure

Siobhan Botwright et al. Nat Rev Nephrol. 2025 Dec.

Abstract

Kidney failure is the most advanced stage of chronic kidney disease, at which point patients require kidney replacement therapy (KRT) in the form of kidney transplant or lifelong dialysis to survive. Although many governments seek to provide KRT for patients with kidney failure under publicly funded health schemes, KRT requires considerable financial and human resources, which may need to be diverted from other health programmes. In deciding which KRT services to provide, to whom, and under which conditions, economic evaluation can show the trade-off between the cost and benefit of different policy options. This Guideline has been written for nephrologists, clinicians and policymakers, to build confidence in requesting, contributing towards, and using the results from economic evaluation studies. It is aimed at outlining the cases in which economic evaluation may support KRT policymaking and to lay out good practice for economic evaluation of KRT services. Recommendations cover the process of developing the policy and research questions, conducting the economic evaluation and interpreting results for policy.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors declare no competing interests.

References

    1. Hariharan, S., Israni, A. K. & Danovitch, G. Long-term survival after kidney transplantation. N. Engl. J. Med. 385, 729–743 (2021). - PubMed - DOI
    1. Himmelfarb, J., Vanholder, R., Mehrotra, R. & Tonelli, M. The current and future landscape of dialysis. Nat. Rev. Nephrol. 16, 573–585 (2020). - PubMed - PMC - DOI
    1. Thurlow, J. S. et al. Global epidemiology of end-stage kidney disease and disparities in kidney replacement therapy. Am. J. Nephrol. 52, 98–107 (2021). - PubMed - DOI
    1. Harris, D. C. H. et al. Increasing access to integrated ESKD care as part of universal health coverage. Kidney Int. 95, S1–S33 (2019). - PubMed - DOI
    1. Francis, A. et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat. Rev. Nephrol. 20, 473–485 (2024). - PubMed - DOI

MeSH terms

LinkOut - more resources