The number of patients receiving renal replacement therapy (RRT) world-wide is estimated at more than 1.4 million. The incidence of RRT is continuously growing by approximately 8% annually.
Despite the heavy burden of end-stage renal disease (ESRD) in developing countries, about 80% of the world’s RRT patients live in developed countries (mainly Europe, Japan or North America).
Given the gap between the low per capita spending on public healthcare and high costs of hemodialysis, in developing countries maintenance hemodialysis is often confined to the private sector. Thus, provision of RRT depends primarily on whether the patient can directly afford treatment costs. Consequences are tragic. In India, less than 10% of ESRD patients receive RRT, while more than 70% of those starting on dialysis die or stop treatment, because of the high cost, within the first 3 months.
There is an urgent need to explore ways of providing high quality, lower cost RRT services.