A regional end-stage renal disease program: twelve years' experience

As of 31 December 1978, 558 patients with end-stage renal disease had been treated with transplantation (150), home dialysis (109), and center dialysis (299). Three hundred twenty-eight patients survived--194 (59%) in center, 51 (15%) at home, and 83 (25%) with functioning grafts. The number and age of new patients continue to increase. Significantly more deaths occur among center dialysis patients than among transplant recipients or home patients. Cadaveric donors provide 71% of transplanted kidneys. The increase in new and older patients without a commensurate increase in cadaver organs results in a declining transplantation rate. Home dialysis training has not decreased. Home dialysis and transplantation can treat about 50% of all new patients. Equilibrium in the end-stage renal disease population will occur when 632 patients per million are receiving treatment. Of these, about 500 will be on center dialysis and will need about 100 stations per million population.