Purpose of review: Recent trends in incident rates of end-stage renal disease (ESRD) in the USA suggest that ESRD incidence may be leveling off after decades of increases. This article examines recent worldwide ESRD incidence trends as well as population dynamics for their implications on ESRD treatment.
Recent findings: There is some evidence that ESRD rates have stabilized in countries with relatively high gross domestic product and where renal replacement therapy has been widely available for many years. However, population dynamics, particularly the aging of populations, as well as increases in diabetes prevalence will exert pressure to increase the absolute numbers of people on renal replacement therapy (RRT). In developing countries, the population dynamics are similar, if not more dramatic. Heretofore, access to RRT in developing countries has been limited due to economic limitations. To the extent that these nations approach the economic prosperity of Westernized countries, access to RRT will also increase and the total ESRD population will continue to increase.
Summary: It is likely that the absolute numbers of incident ESRD patients will continue to increase in westernized countries due to the aging of those populations. In developing countries, ESRD incidence will increase to the extent that economic development allows.