Kidney failure affects almost 750,000 people per year in the United States. The disease disproportionately affects the nation’s minority and low-income patients. Compared to whites:
Mortality rates vary depending on the kidney failure treatment. After one year of treatment, those on dialysis have a 15-20 percent mortality rate, with a five-year survival rate of under 50 percent. Persons who receive transplants have a survival rate of about 80 percent after five years.
The best current treatment for kidney failure is kidney transplantation, which requires a donor match, major surgery, and a lifetime regimen of immunosuppressant medications to prevent rejection. For those kidney failure patients able to receive a kidney transplant, the outlook is positive; the five-year survival rate for transplant recipients is over 80 percent.
There is an acute shortage of donor organs for kidney failure patients. There are more than 100,000 kidney failure patients on the U.S. transplant waitlist. In 2016, 20,161 kidney transplants were performed in the United States.
The only alternative today to kidney transplantation is dialysis.
Hemodialysis involves pumping a patient’s blood through an external circuit for filtration before it is pumped back into the body. A typical hemodialysis schedule is three sessions per week, for 3-5 hours per session at a medical facility.
Peritoneal dialysis uses the patient’s own abdomen across which waste is exchanged from the blood and flushed out regularly through a permanent tube in the abdomen. Peritoneal dialysis does not require regular trips to a medical facility but still requires regular treatment at home.
Hemodialysis is the far more common type of dialysis — about 90 percent of all dialysis patients.
Medicare coverage is extended to a person of any age who requires either dialysis or transplantation to maintain life. The almost 750,000 people who live with kidney failure are 1 percent of the U.S. Medicare population but account for roughly 7 percent of the Medicare budget.
Medicare spending for kidney failure patients is at $35 billion in 2016.
Hemodialysis care costs the Medicare system an average of $90,000 per patient annually in the United States, for a total of $28 billion.
Spending for transplant patient care is $3.4 billion.