Abstract
Chronic renal insufficiency (defined by a serum creatinine concentration of 1.5 to 3.0 mg per deciliter [133 to 265 μmol per liter]), chronic renal failure (serum creatinine concentration, >3.0 mg per deciliter), and end-stage renal disease should be regarded as parts of a continuum. Of the 300,000 patients who are currently receiving renal-replacement therapy in the United States,1 220,000 receive dialysis therapy and the remainder depend on a successful kidney graft. The current annual increase in the number of patients receiving renal-replacement therapy is 6 to 7 percent; by extrapolation,2 at least 600,000 patients will be receiving such therapy by . . .