Around 10% of the global population is affected by chronic kidney disease (CKD) and over 2 million people suffer from end-stage renal disease (ESRD), which has to be treated by dialysis or kidney transplant. Health care spending on kidney in general and specifically on ESRD is on a rise. In 2014, overall Medicare spending on the treatment of ESRD was over US$ 32 Bn, while the National Health Service (NHS) spends around 3% of its budget on kidney failure services. The burden of kidney diseases is rising in developing countries as well, with nearly half a million patients in China undergoing dialysis (Source: National Kidney Foundation, Center for Medicare and Medicaid Services, NHS).

Rise in prevalence of ESRD is driven by increase in prevalence of diabetes and geriatric population. According to the International Diabetes Federation, globally, the number of adults with diabetes (diagnosed or undiagnosed) is projected to increase from 415 million in 2016 to 642 million by 2040, while people aged 60 years and above are expected to account for 17% of the global population by 2030, up from 12% presently (Source: WHO and International Diabetes Federation).

Based on type of services, the global dialysis centers market can be classified into in-center dialysis, in-center nocturnal dialysis, home hemodialysis, peritoneal dialysis, and other services such as disease management and emergency services. Home dialysis offers benefits such as better outcome and higher level of flexibility over in-center dialysis. However, global statistics indicate that over 85% of the patients prefer in-center dialysis even when health care professionals believe that home dialysis could be a better option for ESRD patients. Preference for home dialysis is lower in the U.S., with over 93% of patients choosing in-center hemodialysis.

In terms of region, the global dialysis centers market can be segmented into North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. Presently, majority of the dialysis centers are located in developed economies such as the U.S., Germany, Japan, Italy, and the U.K. More than 2,200 of the 3,600 dialysis centers operated by Fresenius Medical Care are located in the U.S. In India, less than 30% of the ESRD patients undergo dialysis due to factors such as high cost and lack of access to dialysis centers. Moreover, developing economies such as India and China are expected to present significant opportunities in the market due to rise in affordability among the population and government initiatives to improve access to dialysis services. Nephroplus, the largest chain of dialysis centers in India, plans to use the US$ 15 Mn raised through Series-C funding in 2016 to expand from 100 centers to 500 centers in five years.

Key players in the global dialysis centers market are Fresenius Kidney Care, DaVita, Inc., U.S. Renal Care, Inc., Diaverum, NephroCare (part of Fresenius Medical Care), B. Braun Melsungen AG, Yueda Group, NephroPlus, Apex Kidney Care, Deep Chand Dialysis Center, and Kaikoukai Healthcare Group, among others. The market is expected to continue to consolidate, as larger players such as Fresenius and DaVita acquire smaller companies to reduce price competition and increase market share. In May 2018, DaVita acquired ten dialysis centers of Purity Dialysis, a player based in the U.S.

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