Population growth and aging are posing a challenging threat to health systems worldwide
Global prevalence of CKD
most cases are Stage 3
11-13%
China alone has
119.5 million
CKD-patients
12,832
Prevalence rates of CKD per 100k population
12,500
10,000
7,500
5,000
2,500
0
12,107
11,718
11,387
10,924
9,529
8,404
8,144
7,337
7,180
7,103
6,982
6,023
5,687
5,167
United Kingdom
Germany
Canada
Australia
South Korea
China
Brazil
United States
Japan
India
Iran
Nigeria
Mexico
Russia
South Africa
All stages of CKD are associated with an increased risk of cardiovascular morbidity, premature mortality, and/or decreased quality of life.
CKD is often untreated in its earliest stages and is expensive to manage as it progresses to end-stage renal disease (ESRD).
treatment for chronic kidney disease
being one of the most expensive
In England, CKD costs more than the joint treatments of breast, lung, colon and skin cancers.
- NHS Kidney Care.
CKD is a catastrophic public health situation due to:
· increasing number of cases
· high investment costs
· limited infrastructure and human resources
· late detection
· high rates of morbidity and mortality in dialysis programs
- Treviño BA 2004/Paniagua R.,2007.
In 2010, of 2.89 million people who needed Renal Replacement Therapy (RRT) in Asia and Oceania, only 0.993 million received the therapy.
" Developing countries, with a combined population of over 600 million people, cannot afford renal replacement at all—resulting in the death of over 1 million people annually from untreated kidney failure. [...] In countries such as India and Pakistan, less than 10% of all patients who need it receive any kind of renal replacement therapy. In many African countries there is little or no access to RRT, meaning many people simply die".
Mexico occupies the place worldwide in CKD mortality rate
with a survival estimate of only
30.6 months in peritoneal dialysis and 32 months in hemodialysis.
6th
“Funding needed for treating these patients
is considerable, out of proportion
to the overall healthcare spending”
Australia: treatment for all current and new cases of ESRD to 2020 is calculated at $12 billion.
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US: treatment of CKD to exceed $48 billion per year, and the ESRD program consumes 6.7% of the total Medicare budget to care for less than 1% of the covered population.
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China: the economy will lose US$558 billion over the next decade due to effects on death and disability attributable to chronic cardiovascular and renal disease.
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Uruguay: annual cost of dialysis is close to $US 23 million, representing 30% of the budget of the National Resources Fund for specialized therapies.
ESRD patients in Asia are
20 years younger
versus in developed countries.
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Many patients receive dialysis only when uremia becomes overwhelming and/or life-threatening complications like hyperkalemia, fluid overload, encephalopathy or metabolic acidosis force presentation.
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In a cohort of more than 1,200 consecutive ESRD patients referred to a public sector hospital, the mean hemodialysis duration was <1 month. About 10% of patients died in the hospital and another 60% left the program for financial reasons and having to travel long distances to receive healthcare, leading to discontinuation or death.
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Hemodialysis sessions are cut short to accommodate extra patients, given the shortage of trained manpower, nephrologists, dialysis technicians, nurses, vascular access surgeons, and support staff. Emigration of trained personnel to Europe, North America an Australia further worsens the shortage.