Trends in end-stage renal disease. Epidemiology, morbidity, and mortality.

ESRD is always fatal unless recognized and treated appropriately. In the United States, the incidence of ESRD is increasing. Fortunately, both mortality among dialysis patients and the rate at which ESRD has been increasing over the past decade are declining. Obviously, the primary goal should be prevention of ESRD. Aggressive treatment of hypertension and hyperglycemia is likely to reduce the incidence of ESRD. Screening for diabetes and hypertension may be a fruitful approach to reduction in ESRD rates, because many patients present with renal failure after prolonged periods of undiagnosed hypertension or type 2 diabetes.