At the end of 2016, there were around 3.7 million patients being treated for end-stage renal disease (ESRD) worldwide. This number increases by approximately 6% each year, which is significantly higher than the population growth rate. Out of those 3.7 million patients, almost 3 million were undergoing dialysis treatment (either haemodialysis or peritoneal dialysis), and around 750,000 were living with kidney transplants. This proportion of more than three quarters of the patients being treated with dialysis has remained relatively stable over the past years.

The prevalence of people treated for end-stage renal disease shows a high degree of variation across countries. Taiwan shows the highest ESRD prevalence (3,490 per million population – pmp), followed by Japan (2,720 pmp) and the United States (2,180 pmp).

In the European Union, there is an average of 1,160 patients per million inhabitants. The countries with the highest prevalence are Portugal, Germany, Cyprus, Belgium and France. 8.5% of the EU population suffers from diabetes.

The global average of ESRD prevalence remains much lower (510 pmp), which is largely explained by the fact that, in many countries, access to treatment is still very limited and a large number of people with terminal renal failure do not receive treatment. Indeed, a comparison of national GDPs per capita with ESRD prevalence suggests that economic factors may impose restrictions on treatment. Moreover, the most common causes of kidney disease are also more widespread in developed countries.

From a global view, most dialysis patients can be allocated to three geographical regions: the United States, the EU and Japan, which together represent 40% of all dialysis patients. However, the dialysis patient population growth rate is much lower (between 1 and 4% per year) in those countries than in other regions such as Asia (excluding Japan), Latin America, the Middle East and Africa (8 to 9% per year).

Haemodialysis (HD) remains the most common treatment modality, with approximately 2.65 million patients – 89% of all dialysis patients. Peritoneal dialysis (PD) represents around 341,000 patients – 11%. However, this distribution ratio varies quite significantly between countries, although haemodialysis remains the most used treatment in the majority of countries. In Europe, out of 589,000 patients, 56% are being treated with haemodialysis, 5% with peritoneal dialysis, and 39% are living with kidney transplants. Transplantation is the most effective therapy; it is also the fastest growing of the three forms of treatment (+3% each year).

Read more about therapies.

A predominant number of haemodialysis patients undergo treatment in dialysis centres. There are about 40,000 such centres worldwide, 61% of which are in private or corporate ownership. The remaining 31% lay in the public sector or belong to healthcare organisations. There are large geographical divergences however: while 99% of the American (US) centres are private or corporate, only 44% are so in the European Union.

Within the EU, last year 329,000 patients received a total of 49.8 million HD treatments across 5,410 centres.

Source: Fresenius Medical Care – International Strategic Development, 2016.

Check out our infographic document for a brief overview of CKD and its consequences: