Deadly Kidney Ailment Spurs Need for Dialysis, Transplants

(Bloomberg) -- A kidney ailment so severe that sufferers must undergo regular dialysis or receive a transplant will afflict 14.5 million people worldwide by 2030, a study found.

The growing global burden of end-stage renal disease is spurring the need for kidney replacement therapies to avert more than 2 million deaths globally, the Brussels-based International Society of Nephrology said in a report Friday. Sufferers, who numbered 9.7 million in 2010, face uncertain care, with almost two-thirds of patients likely to miss out on lifesaving treatment because of economic, social, and political factors.

Low-income countries report the highest incidence of the condition, but only 4 percent of people living there have access to blood-cleaning dialysis or transplantation. That compares with 60 percent of people in wealthy nations, according to the 172-page report released in Melbourne, where the society is holding its 2019 world congress.

“The big issue is the lack of access to dialysis in so many parts of the world,” said Peter Kerr, director of nephrology at Melbourne’s Monash Medical Centre and chair of the kidney society’s Oceania & Southeast Asia regional board. “That obviously comes with quite a cost burden, and it’s difficult for low- and middle-income countries to get their head around it.”

$80 Billion Market

The number of patients needing dialysis is increasing about 6 percent a year, creating a global market worth about 71 billion euros ($80 billion) last year, according to a March 18 presentation by Fresenius Medical Care AG.

The company, a subsidiary of Bad Homburg, Germany-based Fresenius SE, said it’s the world’s biggest provider of dialysis products and services, treating more than 330,000 patients in about 4,000 clinics in some 50 countries.

Read More: Fresenius to Double Down on Home Dialysis

Worldwide, an estimated 21.3 million people suffered chronic kidney disease in 2016, an 89 percent increase since 1990, a study last year showed. The number of deaths doubled to 1.2 million over the same period.

The life-threatening condition is caused by permanent, cumulative damage to the organ, often as a consequence of inadequately treated type-2 diabetes or hypertension. The number of adults living with diabetes quadrupled to 422 million from 1980 to 2014, while the number with elevated blood pressure almost doubled to 1.13 billion from 1975 to 2015, according to the study last year.

Diabetes, Hypertension

The increase in diabetes and hypertension cases accelerated fastest in low- and middle-income countries, the authors said.

Many developed countries spend 2–3 percent of their health-care budgets on treatment for patients with end-stage kidney disease, even though these patients comprise just 0.1–0.2 percent of the total population, the report by the International Society of Nephrology said.

For many developing countries, preventing the disease is significantly more cost-effective than treating patients, Kerr said. Screening for diabetes and using medications to control blood-sugar levels and high blood pressure can prevent the kidney complication.

So-called hemodialysis, which involves cleaning blood through a machine to remove waste and excess fluid, may cost about $100,000 per patient a year in some high-income countries. That led the society to call for broader access to cheaper alternatives, such as peritoneal dialysis, in which a catheter is placed into the patient’s abdomen and fluid is added to collect and remove waste from the body.

Baxter International Inc., based in Deerfield, Illinois, is the dominant supplier of equipment for peritoneal dialysis.

“The trends noted in the International Society of Nephrology report are, unfortunately, not surprising given the growing incidence of kidney disease, but they are simply unacceptable,” Laura Angelini, general manager of Baxter’s global renal care business, said in an email. Baxter, she said, is working to try to broaden access to “more efficient product and service options,” like starting care earlier to slow disease progression.

To contact the reporter on this story: Jason Gale in Melbourne at j.gale@bloomberg.net

To contact the editors responsible for this story: Brian Bremner at bbremner@bloomberg.net, Marthe Fourcade, Tony Jordan

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