Future evolution of the ESRD patient population--a perspective for the year 2000

Renal replacement therapy of the next decade in Europe will be strongly influenced by certain epidemiological developments, which can be observed in some parts of the world since several years. The overall incidence rates of new patients will rise up to 300 pmp per year, the prevalence rates of patients on treatment will exceed 1000 pmp in some European countries as well as in Japan and in the USA. This is due to a more than proportional increase in the acceptance rates for people older than 65, mostly patients with type II diabetes and hypertensive nephropathy. In Europe, the proportion of patients with NIDDM and diabetic nephropathy shows marked regional differences, which may be more or less important for the development of the whole patient population. Since diabetes as well as hypertensive disease are conditions with high risks for non-renal complications, one cannot expect important improvements in patient survival in spite of technical developments in dialysis therapy.