Aging Problem of the Patient Population on Maintenance Hemodialysis: An Important Issue for Clinical Nephrology to Focus Upon
Hemodialysis (HD) is now an indispensable medical treatment; it is very often introduced to treat end-stage renal disease (ESRD). Kidney transplantation and continuous ambulatory peritoneal dialysis (CAPD), which are other renal replacement therapies (RRT), have not markedly increased throughout the world, compared with HD. HD is typically more often selected; the number of maintenance HD patients has been steadily increasing and it has exceeded 2.2 million throughout the world. The United States Renal Data System (USRDS) revealed the percent change in the averaged ESRD incidence rates in 2013/14 versus that in 2001/02. According to that report, the greatest increases in the incidence of treated ESRD were reported for Thailand (1,009%), Bangladesh (643%), Russia (291%), the Philippines (190%), Malaysia (162%), the Republic of Korea (101%), and the Jalisco region of Mexico (93%) [1]. Many of these are emerging countries and developing Asian countries. Indeed, all of the physicians and nephrologists should think of appropriate measures to suppress or retard the progression of chronic kidney disease (CKD) to ESRD in these countries to decrease the patients who need HD as well as to cut back the explosively increasing medical expenditure for HD. Fortunately, great efforts have been made without interruption to early detect CKD and more skillfully treat it to prevent ESRD thanks to various programs of the International Society of Nephrology (ISN) and the experts in these countries.
Acknowledgement
The surveys mentioned in the article were funded by Ministry of Health, Labour and Welfare, Japan.
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