Currently

the growing number of end-stage renal disease patients in developing countries consumes a greater proportion of healthcare budget

and increasing attention is being focused on the cost-effectiveness of the procedure.We aimed to assess the cost-effectiveness of living-related renal transplantation （RTx） as compared with that for hemodialysis （HD） and identify medical factors associated with charges for RTx in northwestern China.This study was a retrospective analysis of 372 patients on regular HD and 122 living-related kidney transplant recipients on regular follow-up for at least 3 years in northwestern China.All data on charges included HD procedure

RTx procedure

the cost for donor operation

immunosuppression

and follow-up medicare.The average annual cost to all patients on HD and kidney recipients during the first 3 years after RTx was $14482/$31027

$13502/$11038

and $13382/$10243

respectively.The three variables were found to be significant in predicting increased costs for RTx:diltiazem administration

acute rejection and infection complications.We concluded that from the second year on

RTx in China was more effective and less costly than dialysis treatment

although recipients without diltiazem administration and with acute rejection or infection proved costlier during the first year after transplantation.