In a recent commentary Kam Kalantar-Zadeh writes:
"Over the past 10 years the annual ESRD incidence rate per million U.S. population has remained stagnant or even shown sporadic downward trends.
More interestingly, and probably for the first time in this country, the absolute number of new dialysis patients per year has declined despite ongoing population growth. Does this mean that the growth of the dialysis industry in the U.S. will come to a grinding halt?"
"Over the past 10 years the annual ESRD incidence rate per million U.S. population has remained stagnant or even shown sporadic downward trends.
More interestingly, and probably for the first time in this country, the absolute number of new dialysis patients per year has declined despite ongoing population growth. Does this mean that the growth of the dialysis industry in the U.S. will come to a grinding halt?"
What explains this statistic?
1. Later starts on dialysis. The early-start program has been discredited. The spike in new starts reflected observational data that early start on dialysis is associated with improved survival and financial incentives to providers.
2. Despite growth in the incidence of elederly patients starting dialysis, the recognition that not all elderly patients want dialysis - more palliative strategies offered to old and very-old patients with ESRD.
3. Strategies to slow the progression of kidney disease are working - angiotensin blockade, more aggressive treatment of hypertension and diabetes, and better treatments for reversible forms of kidney failure (for example, glomerulonephritis).
