Demography of Uremia and its Treatment

The success of dialysis and kidney transplantation during the past 25 years poses a challenging perspective for the next quarter century. Lives of patients who would otherwise die of end stage renal failure (ESRF) can be usefully prolonged by renal replacement therapy (RRT) and there is a confident expectation in developed countries that these treatments will be offered to those in need and a perplexing dilemma in developing countries over what should be done. The rate of acceptance of new patients for treatment in western European countries indicates a need of treatment for at least 60 new patients/million population per year [1]. This is confirmed by data from clearly defined catchment populations [2]. The clinical need is greater in the United States [3] and certainly greater still, but largely untouched, in the huge populations of Africa, South America, Asia, and China [4].