Prevalence of Patients Receiving Publicly Funded Renal Replacement Therapy in Brazil: Regional Inequities and Costs

From 2008 to 2013 there was a 25% increase in the absolute number of hemodialysis sessions (10,022,962; 12,561,623). This resulted in an estimated overall increase of 18% in the ratio of patients on hemodialysis per million population (352 pmp; 416 pmp). There were considerable differences among Brazilian States regarding the prevalence of patients with ESRD on hemodialysis. In 2013, the prevalence ranged from 173 pmp (State of Amazonas) to 531 pmp (State of Minas Gerais). The leading Brazilian States, in absolute number of patients, were São Paulo (19,301), Minas Gerais (10,940) and Rio de Janeiro (8,510), all of them in the southeast region. In 2013, the overall mean mortality rate was 18.4%. From 2008 to 2013, the renal transplantation rate increased from 35.2 to 41.6 transplants per year per million inhabitants. In 2013, hemodialysis was the most frequent modality of therapy, corresponding to 87.1% of the cases, followed by CAPD (9.2%) and APD (3.7%).