ESRD rate worldwide is growing faster than population

The prevalence of dialysis therapy for kidney failure is increasing much faster than population growth in most parts of the world, according to a new study. The study, “The Rapidly Growing Global Burden of End-Stage Renal Disease – An Analysis of the Change in Maintenance Dialysis Prevalence between 1990 and 2010” (Abstract 4163), is presented at ASN Kidney Week 2013.

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To accurately report the trajectory of treated ESRD rates at the global and regional level between 1990 and 2010, Bernadette Thomas, MD, from the University of Washington, and her colleagues examined data from the Global Burden of Disease database, the largest existing database for global causes of illness and death. They also analyzed data from national and regional ESRD registries and performed a literature review of studies from 1990 and 2010. Data from 26 countries that lack routine access to dialysis were excluded. Data from 23 countries providing 100% dialysis access and 138 countries providing partial dialysis access were included.

Among the major findings:

Worldwide, there has been a 165% increase in dialysis treatments for ESRD over the past two decades.
The global prevalence of ESRD treatment with dialysis for countries with universal dialysis access increased by 134% after adjusting for population growth and aging (145% in women vs 123% in men).
For countries whose populations lack universal dialysis access, adjusted prevalence increased by 102% (116% for women vs 90% for men).
The five world regions not experiencing a substantial increase in dialysis prevalence include Oceania, South Asia, central sub-Saharan Africa, Eastern Europe, and tropical Latin America.

The findings indicate that the significant growth in dialysis therapy is strikingly out of proportion to population growth for a majority of regions in the world, the authors said.

“This emphasizes the need for early chronic kidney disease detection and treatment targeting ESRD prevention, since continued rise in prevalence of maintenance dialysis may not be sustainable,” the investigators wrote.

Disclosures: Rajnish Mehrotra is an ad hoc consultant for Baxter Healthcare, Novartis, Shire, Johnson & Johnson; receives research funding from DaVita; and honoraria from Amgen, Baxter, DaVita, Shire, Takeda, and Vifor. Jonathan Himmelfarb is a consultant for and receives honoraria from Ardea Biosciences, Thrasos Innovations, Abbott, Affymax, Xenon; has an ownership interest in Thrasos; and receives research funding from POM Wonderful, Bristol Myers Squibb.

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