Abstract: FR-PO810

A Simulation of Demand-Supply Imbalance in Dialysis Care in India

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD


  • Ray, Achintya, Tennessee State University , Nashville, Tennessee, United States
  • Putatunda, Bhabendra, Nephrology Associates PC, Murfreesboro, Tennessee, United States

About 10% of India’s 1.3 Billion people suffer from Chronic Kidney Disease (CKD). An average of 15% of urban Indian population suffers from CKD. That number rises to 50% for some cities. Demand (CKD/ESRD treatment including dialysis) is growing at a rate of about 31% in India (compared to about 6% in the USA and 8% in the rest of the world.) About 30% of the CKD cases are estimated to be caused by diabetes and about 20% by hypertension. India has over 70 Million diabetes patients, a number that is estimated to double by 2040. A third of the diabetes cases will develop CKD. About 200,000 patients develop ESRD in India per year of which 70%-80% start dialysis treatment while about two-thirds of them are eventually ceasing the treatment due to resource limitations leading to premature death.


Published studies are used to extract economically meaningful numbers that can be used to draw quantifiable data measuring the demand-supply imbalance. Various projection methods are used to arrive at measures of long-term (through 2035) prevalence in the country for diabetes, dialysis and CKD cases. Furthermore, published studies are used to estimate the lower and upper bounds of CKD prevalence. Sparse evidences are scanned to estimate the number of dialysis centers and machines in different parts of the country and their abilities to meet the current demands. Reasonable assumptions are made to simulate the demand and supply of dialysis treatment based on the upper and lower bounds of the CKD estimates.


About 87% to 93% of the demand for dialysis treatment may not be currently met in India. These estimates may be conservative. It is estimated that about 40,000-68,000 additional dialysis machines may be needed to serve India’s current demand. These numbers may increase by 200%-300% by 2035 under various scenarios.


This study is of the first to harness a sparse and widely varying literature on the state of dialysis treatment to make meaningful estimates of demand-supply imbalance in Indian dialysis care market. The sparseness of the existing studies and the gravity of the magnitude of the imbalance point to need for more in-depth studies involving population health and healthcare marketplace data in India.