Skip to main content
Subscribe
  • Login
  • My Account
  • Logout
  • Register For Free
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HLTH 2024
    • Sponsored Content: Vital Signs Blog
  • Opinion
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • 40 Under 40
    • Best Places to Work in Healthcare
    • Healthcare Marketing Impact Awards
    • Innovators Awards
    • Diversity Leaders
    • Leading Women
    • Best in Business Awards
    • The 2030 Playbook Conference
    • Innovations in Patient Experience
    • Leading Women Conference & Awards Luncheon
    • Leadership Summit
    • Workforce Summit
    • Best Places to Work Awards Gala
    • Diversity Leaders Gala
    • - Looking Ahead to 2025
    • - Financial Growth
    • - Hospital of the Future
    • - Value Based Care
    • - Looking Ahead to 2026
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Skilled Nursing Facilities
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
    • Sponsored Content
MENU
Breadcrumb
  1. Home
  2. Government
October 11, 2014 12:00 AM

Dialysis demand strong as kidney disease grows

Steven Ross Johnson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    Demand for kidney dialysis is expected to increase in the U.S. as the elderly population grows and the prevalence of chronic conditions such as diabetes, hypertension and heart disease rises.

    International statistics show that the U.S. has a higher rate of dialysis utilization than all other advanced countries except Japan, and the highest rate of mortality.

    The first dialysis center was started in the 1960s, and coverage for expensive dialysis treatment was extended to all Americans with end-stage renal disease by the establishment of Medicare's End Stage Renal Disease Program in 1973. Currently, nearly 400,000 Americans receive dialysis care under that program.

    Critics say the cost of the program has ballooned while it has produced poorer health outcomes for ESRD patients compared with other advanced countries. The average annual cost for a dialysis patient, including hospitalization, is between $70,000 and $100,000 per patient, higher than in most European countries, said Dr. Edward Jones, a nephrologist at the Einstein Medical Center, Philadelphia.

    In 2012, about 370,000 ESRD patients in the Medicare program received dialysis treatment in 5,800 facilities, according to a March report to Congress by the Medicare Payment Advisory Commission. Medicare spent a total of $10.7 billion for dialysis in 2012, a 6% increase from 2011. That spending covered the dialysis procedures, medications and ESRD-related lab tests.

    The majority of centers are freestanding clinics, which make up 92% of all dialysis facilities in the U.S. and accounted for 93% of Medicare dialysis spending in 2012. While the number of hospital-based and not-for-profit facilities has decreased in recent years, the share of for-profit centers has increased, from 82% in 2008 to 86% by 2013, according to MedPAC.

    The growth in dialysis facilities, which has increased by 6% annually over the past five years, has been accompanied by an increase in the population of Americans diagnosed with ESRD. That total rose from 411,000 in 2001 to more than 615,000 by 2011 as more Americans developed chronic conditions such as diabetes and hypertension. While the share of Americans receiving dialysis dropped by 2 percentage points during that period, the overall number of patients receiving dialysis increased from 296,000 in 2001 to more the 430,000 by 2011, according to government figures. The incidence rate for ESRD in the U.S. was 425 per million people in 2010, second only to Mexico.

    About 63% of ESRD patients are under age 65, according to MedPAC. Hispanics and Asian Americans were the fastest-growing ethnic groups newly diagnosed with ESRD from 2006 to 2011.

    Currently, more than 20 million Americans have some level of chronic kidney disease. That's related to an increase in diabetes, the most common cause of renal failure. Experts predict that as the prevalence of diabetes increases, so will the demand for dialysis.

    The U.S. had the second-highest rate of dialysis utilization among advanced countries after Japan, according to a 2011 report by the Organization for Economic Cooperation and Development. The U.S. rate of 125.7 per 100,000 population trails Japan, which had a rate of 186. The next closest country, Germany, had a rate of 80.7per 100,000 population, with France at 52, Canada at 66, Italy at 76, and the U.K. at 41.

    But the U.S. has the highest mortality rate for ESRD patients among the advanced countries, according to the 2011 OECD report.

    About 20% of American ESRD patients die annually, a rate more than twice that of Japan. One of the reasons for the disparity could be that dialysis patients in other countries tend to suffer from less comorbidities, said Dr. Leslie Spry, a spokesman for the National Kidney Foundation and medical director of the Nebraska-based, Dialysis Center of Lincoln.

    In the U.S., average life expectancy for people on dialysis is about eight years for patients between the ages of 40 to 44 and four-and-a-half years for patients between 60 and 64. A comparison of two-year survival rates of patients on dialysis published in the Journal of the American Society of Nephrology found that the U.S. had a rate of 64%, significantly lower than the U.K., France, Canada, Spain and Japan, which had the highest rate at 83%.

    According to a 2013 report by the U.S. Renal Data System, 52% of hemodialysis patients and 61% of patients receiving peritoneal dialysis who began treatment in 2006 were still alive three years later.

    Both modalities are covered by Medicare, with hemodialysis used by more than 90% of the more than 400,000 dialysis patients. Hemodialysis uses a machine to filter wastes and remove extra fluid directly from the blood. Peritoneal dialysis uses the lining of the abdominal cavity and a solution to remove wastes and extra fluid from the body.

    Follow Steven Ross Johnson on Twitter: @MHSjohnson

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Legal-government-0225
    HHS lawsuit by Democratic AGs aims to stop restructuring, layoffs
    GettyImages-654573744.jpg
    Federal watchdog to retract medical debt collection opinion
    Most Popular
    1
    Here are new state healthcare laws taking effect in 2025
    2
    Meet Modern Healthcare's 2025 Leading Women
    3
    New York-Presbyterian layoffs affect 2% of employees
    4
    Evernorth, Optum, CenterWell units buoyed insurers in Q1
    5
    Epic CEO Judy Faulkner on AI, antitrust and consolidation
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2025. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HLTH 2024
      • Sponsored Content: Vital Signs Blog
    • Opinion
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • 40 Under 40
        • Best Places to Work in Healthcare
        • Healthcare Marketing Impact Awards
        • Innovators Awards
        • Diversity Leaders
        • Leading Women
        • Best in Business Awards
      • Conferences
        • The 2030 Playbook Conference
        • Innovations in Patient Experience
        • Leading Women Conference & Awards Luncheon
        • Leadership Summit
        • Workforce Summit
      • Galas
        • Best Places to Work Awards Gala
        • Diversity Leaders Gala
      • Virtual Briefings
        • - Looking Ahead to 2025
        • - Financial Growth
        • - Hospital of the Future
        • - Value Based Care
        • - Looking Ahead to 2026
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Skilled Nursing Facilities
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing
      • Sponsored Content