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End-Stage Renal Disease in Statistics:

The US v. Europe and Asia

More than two million people worldwide are being treated for end-stage renal disease (ESRD), and treatment models and access to treatment widely differ. Here’s what to know about ESRD treatment modalities around the world, patient survival rates and more.
icon of kidneys that represent kidney disease in america
icon of kidneys that represent kidney disease in america

Kidney Disease in the U.S.

661,000
Americans

have kidney failure and of these, 468,000 are receiving dialysis.

37 million
people

have chronic kidney disease (CKD) and 9 out of 10 of these people don’t know they have the condition.

highest
in the world

American rates for kidney failure are among the highest in the world and continue to increase.

$114
billion

Medicare spent $114 billion on ESRD and CKD treatment in 2018

most common cause of death

The most common cause of death in ESRD patients is sudden cardiac death

Top 5 States with the Highest Incidence of Kidney Disease

  • Alabama
  • Mississippi
  • Tennessee
  • Georgia
  • North Carolina
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Treatment

80 of U.S. dialysis patients begin treatment with a catheter
Compared to 23% of dialysis patients in Europe
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icon of the globe to show transplant rates internationally

Transplant Rates:
U.S. versus Europe

30% of ESRD patients in the US receive kidney transplantation compared to:

  • More than 60% in Norway and Iceland
  • Less than 5%-10% in some Asian and Eastern European countries

Countries with the highest transplant rates also have the lowest incidence of ESRD.

Pre-emptive Transplant

  • A pre-emptive transplant increases quality of life and allows patients to live longer.
  • 1%-2% of U.S. patients receive a pre-emptive kidney transplant compared to up to 40% in the UK
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Home Dialysis

45%

of ESRD patients in Hong Kong receive home dialysis

23%-31%

of patients in New Zealand, Colombia, Thailand, and the Jalisco region of Mexico receive home dialysis

3-6%

of dialysis patients in Canada, Denmark, Finland, the Netherlands, Sweden, the United Kingdom, and Scotland receive home dialysis

<2%

less than 2% of ESRD patients in the US receive home dialysis

In-Center

The majority of ESRD patients around the world receive dialysis treatment in-center
In Japan, in-center dialysis is favored over home dialysis because centers are easily accessible (near public transportation) and kidney donation rates are low.
dialysis

Vascular Access Usage

Patients with arteriovenous fistula

91%

Japan

69%

Europe

68%

U.S.

Patients with CVC

45%

Canada

38%

Belgium

Pre-dialysis Education

Patients who receive pre-dialysis care

70%

Japan

76%

Europe

69%

U.S.

Patients with AV fistula at dialysis initiation

84%

Japan

50%

Europe

28%

U.S.

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Survival Rates

The death rates among U.S. dialysis patients are no longer decreasing.

  • Unadjusted five-year survival was 60% in Japan, 39% in the U.S., and 41% in Europe for patients starting dialysis, and unadjusted five-year survival was 52% in Malaysia and 44% in Taiwan.
  • Unadjusted five-year survival was 52% in Malaysia and 44% in Taiwan.
  • Survival rates for ESRD are higher in Europe than the U.S. This could be explained by the inferiority of national standards of care, a higher prevalence of patients with diabetes and differences in practice patterns.
  • Survival rates in Japan and other east Asian countries substantially exceeds other countries. This could be because of lower background mortality and fewer transplant recipients in these countries.
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The Advancing American Kidney Health Act Could Impact Your Patients, Clinic and Kidney Care Staff

See How & What You Can Do