Kidney Disease: Worldwide Crisis

The vast majority of ESRD patients are unable to gain access to dialytic therapy because of poverty, ignorance and lack of healthcare delivery systems. Even those who can manage to avail themselves of maintenance dialysis facility, continue to suffer from complications of uraemia due to inadequate dialysis. Because of the high costs involved in setting up and running haemodialysis units, a sudden growth in the number of dialysis units is not expected in the near future. Continuous ambulatory peritoneal dialysis (CAPD) has yet to gain wide acceptance. A successful renal transplant remains the only viable form of renal replacement therapy. Unless the policy makers decide to make special budgetary allocations for care of ESRD in developing countries, most of the patients would continue to die without receiving the benefits of modern therapy.

- Of the 2 million people who receive treatment for kidney failure, the majority are treated in only five countries – the United States, Japan, Germany, Brazil, and Italy. These five countries represent only 12% of the world population. Only 20% are treated in about 100 developing countries that make up over 50% of the world population.

- Chronic kidney disease is a worldwide health crisis. For example, in the year 2005, there were approximately 58 million deaths worldwide, with 35 million attributed to chronic disease, according to the World Health Organization

- Noncommunicable diseases (such as heart disease, diabetes, or kidney disease) have replaced communicable diseases (such as influence, malaria, or AIDs) as the most common causes of premature death worldwide. An estimated 80% of this burden occurs in low- or middle-income countries, and 25% is in people younger than 60 years

- In people aged 65 through 74 worldwide, it is estimated that one in five men, and one in four women, have CKD.

- In Australia, treatment for all current and new cases of kidney failure through 2020 will cost an estimated $12 billion.

- In England, according to a recent report published by NHS Kidney Care, chronic kidney disease costs more than breast, lung, colon and skin cancer combined.

- In Uruguay, the annual cost of dialysis is close to $ US 23 million, representing 30% of the budget of the National Resources Fund for specialized therapies.

- In China, the economy will lose US$558 billion over the next decade due to effects on death and disability attributable to heart disease and kidney disease.

- In the US, treatment of chronic kidney disease is likely to exceed $48 billion per year. Treatment for kidney failure consumes 6.7% of the total Medicare budget to care for less than 1% of the covered population.

- In middle-income countries, treatment with dialysis or kidney transplantation creates a huge financial burden for the majority of the people who need it. In another 112 countries, many people cannot afford treatment at all, resulting in the death of over 1 million people annually from untreated kidney failure.

- It is estimated that number of cases of kidney failure will increase disproportionately in developing countries, such as China and India, where the number of elderly people are increasing.

- More than 80% of all patients who receive treatment for kidney failure are in affluent countries with universal access to health care and large elderly populations.

- Over 2 million people worldwide currently receive treatment with dialysis or a kidney transplant to stay alive, yet this number may only represent 10% of people who actually need treatment to live.

- According the 2010 Global Burden of Disease study, chronic kidney disease was ranked 27th in the list of causes of total number of deaths worldwide in 1990, but rose to 18th in 2010. This degree of movement up the list was second only to that for HIV and AIDs

- 10% of the population worldwide is affected by chronic kidney disease (CKD), and millions die each year because they do not have access to affordable treatment.

[SOURCE: NKF]