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. 2015 Nov;26(11):2621-33.
doi: 10.1681/ASN.2014101017. Epub 2015 Jul 24.

Maintenance Dialysis throughout the World in Years 1990 and 2010

Bernadette Thomas  1 , Sarah Wulf  2 , Boris Bikbov  3 , Norberto Perico  4 , Monica Cortinovis  4 , Karen Courville de Vaccaro  5 , Abraham Flaxman  2 , Hannah Peterson  2 , Allyne Delossantos  2 , Diana Haring  2 , Rajnish Mehrotra  6 , Jonathan Himmelfarb  6 , Giuseppe Remuzzi  7 , Christopher Murray  2 , Mohsen Naghavi  2
Affiliations

Maintenance Dialysis throughout the World in Years 1990 and 2010

Bernadette Thomas et al. J Am Soc Nephrol. 2015 Nov.

Abstract

Rapidly rising global rates of chronic diseases portend a consequent rise in ESRD. Despite this, kidney disease is not included in the list of noncommunicable diseases (NCDs) targeted by the United Nations for 25% reduction by year 2025. In an effort to accurately report the trajectory and pattern of global growth of maintenance dialysis, we present the change in prevalence and incidence from 1990 to 2010. Data were extracted from the Global Burden of Disease 2010 epidemiologic database. The results are on the basis of an analysis of data from worldwide national and regional renal disease registries and detailed systematic literature review for years 1980-2010. Incidence and prevalence estimates of provision of maintenance dialysis from this database were updated using a negative binomial Bayesian meta-regression tool for 187 countries. Results indicate substantial growth in utilization of maintenance dialysis in almost all world regions. Changes in population structure, changes in aging, and the worldwide increase in diabetes mellitus and hypertension explain a significant portion, but not all, of the increase because increased dialysis provision also accounts for a portion of the rise. These findings argue for the importance of inclusion of kidney disease among NCD targets for reducing premature death throughout the world.

Keywords: ESRD; chronic dialysis; diabetes mellitus.

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Figures

Figure 1.
Figure 1.
Age-standardized prevalence per million population of maintenance dialysis in year 2010 for 187 countries. ATG, Antigua and Barbuda; BRB, Barbados; COM, Comoros; DMA, Dominica; E. Med, Eastern Mediterranean; FJI , Fiji; FSM, Federated States of Micronesia; GRD, Grenada and Trinidad; KIR, Kiribati; LCA, Saint Lucia; MDV, Maldives; MHL, Marshall Islands; MUS, Mauritius; SGP, Singapore; SLB, Solomon Islands; SYC, Seychelles; TLS, Timor-Leste; TTO, Trinidad and Tobago; TUN, Tunisia; VCT, Saint Vincent and Grenadines; VUT, Vanuata; WSM, Samoa.
Figure 2.
Figure 2.
Age-standardized incidence rate per million population of maintenance dialysis in year 2010 for 187 countries. ATG, Antigua and Barbuda; BRB, Barbados; COM, Comoros; DMA, Dominica; E. Med, Eastern Mediterranean; FJI , Fiji; FSM, Federated States of Micronesia; GRD, Grenada and Trinidad; KIR, Kiribati; LCA, Saint Lucia; MDV, Maldives; MHL, Marshall Islands; MUS, Mauritius; SGP, Singapore; SLB, Solomon Islands; SYC, Seychelles; TLS, Timor-Leste; TTO, Trinidad and Tobago; TUN, Tunisia; VCT, Saint Vincent and Grenadines; VUT, Vanuata; WSM, Samoa.
Figure 3.
Figure 3.
Contributions of changes in population aging and growth between years 1990 and 2010 to dialysis prevalence per million population for 21 world regions.
Figure 4.
Figure 4.
Age-standardized maintenance dialysis incidence rate per million population for 21 world regions in years 1990 and 2010.
Figure 5.
Figure 5.
Age-standardized maintenance dialysis prevalence per million population for 21 world regions in years 1990 and 2010.
Figure 6.
Figure 6.
Sex-stratified age-standardized maintenance dialysis incidence rate per million population for 21 world regions in year 2010.
Figure 7.
Figure 7.
Estimated percentage of country-specific total health expenditure allocated to prevalent maintenance dialysis using the Thailand dialysis reimbursement paradigm. ATG, Antigua and Barbuda; BRB, Barbados; COM, Comoros; DMA, Dominica; E. Med, Eastern Mediterranean; FJI , Fiji; FSM, Federated States of Micronesia; GRD, Grenada and Trinidad; KIR, Kiribati; LCA, Saint Lucia; MDV, Maldives; MHL, Marshall Islands; MUS, Mauritius; SGP, Singapore; SLB, Solomon Islands; SYC, Seychelles; TLS, Timor-Leste; TTO, Trinidad and Tobago; TUN, Tunisia; VCT, Saint Vincent and Grenadines; VUT, Vanuata; WSM, Samoa.
Figure 8.
Figure 8.
Estimated percentage of country-specific total health expenditure allocated to prevalent maintenance dialysis using the United States dialysis reimbursement paradigm. ATG, Antigua and Barbuda; BRB, Barbados; COM, Comoros; DMA, Dominica; E. Med, Eastern Mediterranean; FJI , Fiji; FSM, Federated States of Micronesia; GRD, Grenada and Trinidad; KIR, Kiribati; LCA, Saint Lucia; MDV, Maldives; MHL, Marshall Islands; MUS, Mauritius; SGP, Singapore; SLB, Solomon Islands; SYC, Seychelles; TLS, Timor-Leste; TTO, Trinidad and Tobago; TUN, Tunisia; VCT, Saint Vincent and Grenadines; VUT, Vanuata; WSM, Samoa.
See this image and copyright information in PMC

Comment in

  • Meeting the World's Need for Maintenance Dialysis.
    Wetmore JB, Collins AJ. Wetmore JB, et al. J Am Soc Nephrol. 2015 Nov;26(11):2601-3. doi: 10.1681/ASN.2015060660. Epub 2015 Jul 24. J Am Soc Nephrol. 2015. PMID: 26209713 Free PMC article. No abstract available.

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