*1WAQAR H. KAZMI, 2SAMINA S KHAN

EDITORIAL

Although dialysis was first described in humans in 1924 by Haas and colleagues in Germany, 1 it was not until the development of the first permanent vascular access in 1960 by Scribner that chronic dialysis became possible.2 Since the passage by Congress of the Social Security Amendment in 1972, which mandated coverage for the treatment for ESRD via Medicare, 3 the number of patients enrolled in the ESRD program in the U.S. has grown dramatically, from approximately 10,000 beneficiaries in 1973 to 397,971 in 1998. This is projected to increase to 661,330 by 2010.4 Concurrently, the national cost of ESRD has increased; the estimated annual cost of ESRD care was over 15 billion dollars in 1998.4 World-wide, the prevalence of treated ESRD was approximately 1,028,000 in the year 2000.5 Clearly, the appropriate management of patients with ESRD and chronic kidney disease (CKD) is a matter of great relevance. There has been great debate regarding the impact of level of residual renal function at the initiation of dialysis, and in this editorial review we will examine issues surrounding the timing of initiation of dialysis. .......CONTINUED.

For Full text contact to:
Prof. Dr. Farah Mansuri
editor@annals-ashkmdc.org

*