Dialysis Access

Abstract

Although the incidence has largely plateaued, the prevalence of end-stage renal disease (ESRD) in the United States continues to increase. As of December 31, 2011, there were approximately 388,000 patients on hemodialysis (HD), 31,200 patients on peritoneal dialysis (PD), and 185,000 patients with a functioning kidney transplant. Renal transplantation is the preferred treatment for ESRD; however, the number of potential recipients continues to outstrip the number of available kidneys. As of 2013, there were about 98,000 patients on the waiting list for kidney transplant, while only between 16,000–17,000 transplants are performed each year (Organ Procurement and Transplant Network Data, November 2013). The disparity between donors and recipients leads to increasing waiting times for kidney transplant (averaging 5–7 years in some areas) with a concomitant increasing need for renal replacement therapy, both for those waiting for kidney transplant and for those patients who are not candidates.