It is estimated that as many as 20 million people in the US suffer from a form of chronic kidney disease, as determined by GFR or proteinuria assays. Many will progress to end stage renal disease (ESRD) and require dialysis or renal transplantation. The US ESRD population currently numbers about 300,000, but this figure is increasing by about 7% per year. Despite the fact that ESRD patients comprise less that 0.6% of the Medicare population, the annual cost of administering the ESRD program ($22.8 billion) represents 6% of the total Medicare budget. It is predicted that by the year 2010, approximately 661,000 people in the US will have ESRD.

The clinical services provided by the Division of Nephrology and Hypertension are largely devoted to the prevention of ESRD in people with chronic kidney disease and treatment of patients with ESRD. We currently manage approximately 300 ESRD patients at several dialysis units throughout the Cleveland metropolitan area. In addition, Division members provide comprehensive inpatient and outpatient consultation services for a variety of other clinical problems, including acute renal failure, fluid and electrolyte disorders, acid-base abnormalities and uncontrolled hypertension. Outpatient services are provided primarily at the MetroHealth campus, but patients are also seen by Nephrology staff at Lee-Harvard and West Park satellite facilities.