Projecting the number of patients with end-stage renal disease in the United States to the year 2015.

The size of the prevalent ESRD population in the United States increased dramatically during the 1990s, from 196,000 in 1991 to 382,000 in 2000. Incidence also increased considerably during the same period, from 53,000 to 93,000 per year. If previous trends in ESRD incidence and prevalence continue, then current levels of health care resources that are devoted to the care of these patients will eventually be unable to meet the demand. This study discusses a Markov model developed to predict ESRD incidence, prevalence, and mortality to the year 2015 and incorporating expected changes in age/race distributions, diabetes prevalence, ESRD incidence, and probability of death. The model predicted that by 2015 there will be 136,166 incident ESRD patients per year (lower/upper limits 110,989 to 164,550), 712,290 prevalent patients (595,046 to 842,761), and 107,760 ESRD deaths annually (96,068 to 118,220). Incidence and prevalence counts are expected to increase by 44 and 85%, respectively, from 2000 to 2015 and incidence and prevalence rates per million population by 32 and 70%, respectively. The financial and human resources that will be needed to care for these patients in 2015 will be considerably greater than in 2005.

[1]  S C Farrow,et al.  Statistical Approach to Planning an Integrated Haemodialysis/Transplantation Programme , 1971, British medical journal.

[2]  J. Skyler,et al.  Diabetes trends in the USA , 2002, Diabetes/metabolism research and reviews.

[3]  F. Port Worldwide demographics and future trends in end-stage renal disease. , 1993, Kidney international. Supplement.

[4]  T. Yoneyama,et al.  Overweight as another nutritional risk factor for the long-term survival of non-diabetic hemodialysis patients. , 1998, Clinical nephrology.

[5]  D Kromhout,et al.  Forecasting the number of diabetic patients in The Netherlands in 2005. , 1993, American journal of public health.

[6]  M. Engelgau,et al.  Diabetes trends in the U.S.: 1990-1998. , 2000, Diabetes care.

[7]  B. Kasiske,et al.  Proteinuria is a risk factor for mortality over 10 years of follow-up. MRFIT Research Group. Multiple Risk Factor Intervention Trial. , 1997, Kidney international. Supplement.

[8]  Ethan M Balk,et al.  K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. , 2002, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[9]  F. Calero,et al.  Effect of angiotensin II receptor blockade on renal disease progression in patients with non-diabetic chronic renal failure. , 2001, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[10]  H. Morrison,et al.  End-stage renal disease in Canada: prevalence projections to 2005. , 1999, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[11]  T A Louis,et al.  Forecast of the number of patients with end-stage renal disease in the United States to the year 2010. , 2001, Journal of the American Society of Nephrology : JASN.

[12]  Ruth Davies,et al.  Simulation model of renal replacement therapy: predicting future demand in England. , 2004, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[13]  F. Port End-stage renal disease: magnitude of the problem, prognosis of future trends and possible solutions. , 1995, Kidney international. Supplement.

[14]  D. Schaubel,et al.  New and prevalent patients with end-stage renal disease in Canada. A portrait of the year 2000. , 1995, ASAIO journal.

[15]  P. Roderick,et al.  Predicting the future demand for renal replacement therapy in England using simulation modelling. , 1997, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[16]  M. Molzahn Future evolution of the ESRD patient population--a perspective for the year 2000. , 1996, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[17]  A. Mokdad,et al.  Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. , 2003, JAMA.

[18]  R. Poveda,et al.  Goodpasture syndrome during the course of a Schönlein-Henoch purpura. , 2002, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[19]  J. Bower,et al.  Risk Factor Paradox in Hemodialysis: Better Nutrition as a Partial Explanation , 2001, ASAIO journal.

[20]  Y Motohashi,et al.  Prediction of end-stage renal disease patient population in Japan by system dynamics model. , 1991, International journal of epidemiology.

[21]  H. Kahyo,et al.  Geographic differences in seasonality of preterm births in Japan. , 1998, Human biology.

[22]  N. Hollenberg,et al.  Angiotensin-converting enzyme inhibition and renal protection. An assessment of implications for therapy. , 1993, Archives of internal medicine.

[23]  W. Marder,et al.  The supply of renal physicians: an analysis of data from the American Medical Association Physician Masterfile. , 1991, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[24]  S. Cañadillas,et al.  Importance of arachidonic acid as a mediator of parathyroid gland response. , 2003, Kidney international. Supplement.

[25]  P Vestergaard,et al.  Predicting future trends in the number of patients on renal replacement therapy in Denmark. , 1997, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[26]  F Vinicor,et al.  The continuing epidemics of obesity and diabetes in the United States. , 2001, JAMA.

[27]  B. Materson,et al.  Prevention of diabetic nephropathy. , 1997, Hospital practice.

[28]  J. Seidell,et al.  The public health impact of obesity. , 2001, Annual review of public health.

[29]  L S Geiss,et al.  Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. , 2001, Diabetes care.

[30]  Renoprotective Effect of Angiotensin II Receptor Antagonists in Experimental Chronic Renal Failure , 2001, American Journal of Nephrology.

[31]  David Johnson,et al.  Planning Patient Care with a Markov Model , 1975 .

[32]  Douglas C. Montgomery,et al.  Forecasting and Time Series Analysis (2nd ed.). , 1992 .

[33]  S C Farrow,et al.  Dialysis and transplantation: the national picutre over the next five years. , 1972, British medical journal.

[34]  H. Morrison,et al.  End-stage renal disease projections for Canada to 2005 using Poisson and Markov models. , 1998, International journal of epidemiology.