Chronic Kidney Disease

Treatment of CKD

Current treatment options for patients with stages 1 to 4 CKD largely focus on the control of underlying conditions, such as hypertension, diabetes mellitus and hyperlipidaemia, in order to try to minimise the risk of further disease progression. In patients with stage 5 CKD, renal replacement therapy (dialysis or transplantation) is indicated. Dialysis and transplantation rates are high, and increasing (Table 1),³ and patients with stage 5 CKD use more healthcare resources than patients with stages 1 through 4 combined. In US Medicare patients, the per-patient cost is nearly 7-fold greater with stage 5 versus stages 1 through 4 CKD.² The projected increases in the number of patients living with stage 5 CKD will confront healthcare providers, policy makers and society with major challenges in the near future.^1,4

Table 1. Global and regional overview of late-stage CKD; dialysis patient numbers and prevalence values per million population at end of 2004 (numbers rounded)

References:
1. Lysaght MJ. Maintenance dialysis population dynamics: current trends and long-term implications. J Am Soc Nephrol. 2002;13(Suppl 1):S37-S40.
2. U.S. Renal Data System, USRDS 2006 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2006.
3. Grassmann A, Gioberge S, Moeller S, Brown G. ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrol Dial Transplant. 2005;20:2587-2593.
4. Xue JL, Ma JZ, Louis TA, Collins AJ. Forecast of the number of patients with end-stage renal disease in the United States to the year 2010. J Am Soc Nephrol. 2001;12:2753-2758.