>You hit the nail on the head. A successful renal transplant is *far* more cost-effective than ongoing dialysis unless there are different payers for transplant vs dialysis in which case they both try to shunt.

The only problem up here is the shortage of organs. To blame are
- effective anti drinking and driving campaigns
- seat belts
- motorcycle helmets

I worked in a renal unit 3 years ago. One new program they are trailing is nocturnal dialysis. You get a 7 days a week, 8 hours per night run on a hemo machine. This allows people to not have to take the time out of the day (or quit work) to go on hemo, plus they get a full proper dose of hemodialysis that actually makes the patients feel relatively normal.

But ya, I've seen the stats, transplants are cheapest.