Each year, approximately 120,000 Americans transition to maintenance dialysis therapy while 90,000 dialysis patients die and 20,000 undergo kidney transplantation. The result is a small positive balance of 10,000 added dialysis patients each year on top of the nation’s prevalent dialysis population of 450,000. The trivial differential, a narrow margin of growth of 2% to 3%, is the basis on which the dialysis industry capitalizes its growth and expansion in the United States.
Now imagine that, in the not-too-distant future, fewer people transition to dialysis and mortality and transplantation rates remain the same. The margin of growth will be even narrower. The positive balance will shrink and may even go into the negative zone. This likely scenario leads to unfilled dialysis chairs and increasing vacancies in hemodialysis shifts. Dialysis centers struggling for survival will try hard to go directly to the source of new dialysis patients, the so-called “ESRD fountains,” such as large community hospitals.
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