2007 Sales

$2.2 billion

Treating Kidney Disease Worldwide

Approximately 1.5 million people with end-stage renal disease (ESRD) – irreversible kidney failure – use dialysis to cleanse their blood of toxins, waste and excess fluid normally removed by healthy kidneys. Many more people with ESRD, mostly in developing countries, currently go untreated. Without dialysis or a kidney transplant, most of these people will die. A shortage of donor organs makes transplant a limited option for most people with ESRD, making dialysis by far the most common treatment.

It is estimated that the incidence of ESRD is growing at a rate of approximately 5 to 7 percent annually, fueled largely by diseases associated with an aging population, such as diabetes and hypertension, which are the leading causes of ESRD. Baxter is committed to increasing access to life-saving dialysis therapy for people with ESRD worldwide.

There are two forms of dialysis: hemodialysis (HD), in which patients generally go to a hospital or clinic several times a week to have their blood pumped through an external filter, or dialyzer; and peritoneal dialysis (PD), a home therapy that uses the body’s own peritoneum – the lining of the abdominal cavity – as a filter to cleanse the blood. Baxter was largely responsible for the development of both therapies, creating the first commercial “artificial kidney” machine in the 1950s, making HD available for the first time, and introducing PD solutions in flexible containers in the late 1970s, making PD a viable alternative to HD. Today, Baxter is the world’s leading manufacturer of products for PD. Baxter also provides products for HD, as well as products for continuous renal replacement therapy (CRRT) for acute renal failure.

In PD, patients infuse dialysis solution into their peritoneal cavity through a surgically implanted catheter in their abdomen. The solution draws toxins, waste and excess fluid from the bloodstream across the peritoneal membrane into the solution, which is then drained from the abdomen and discarded. There are two types of PD therapy: continuous ambulatory peritoneal dialysis (CAPD), in which patients manually infuse fresh PD solution and discard the used solution several times a day; and automated peritoneal dialysis (APD), in which patients hook up to a machine that automatically performs solution exchanges, usually overnight while the patient sleeps.

Baxter manufactures a range of PD solutions used in both CAPD and APD. These include DIANEAL, Baxter’s standard solution for removing waste products from the bloodstream; NUTRINEAL, a specialty non-glucose PD solution that provides supplemental amino acids and improves protein synthesis for some patients; EXTRANEAL, a specialty solution that provides increased fluid removal during PD for some patients; and PHYSIONEAL, a more biocompatible PD solution with a physiologic pH that reduces discomfort and pain on infusion for patients with this problem.

For CAPD, Baxter provides a variety of products to make solution-exchanges easier for patients, and to reduce the incidence of exchange-related infections. These include “twin bag” container systems that combine infusion and drainage in one closed system, making manual solution-exchanges easier to perform while dramatically reducing infection rates.

For APD, Baxter provides the HOMECHOICE PRO and HOMECHOICE PRO Pediatric, which automatically perform solution exchanges overnight while the patient sleeps. Their compact size and ease of use are conducive to home therapy, and also are convenient for patients to take with them when they travel.

For HD, Baxter distributes instruments and disposables, including dialyzers, to dialysis clinics. Other HD products include saline, bloodlines, needles and dialysate solutions.

CRRT is defined as a rapid decline in the kidneys’ ability to clear the blood of toxic substances, as opposed to chronic kidney failure, which occurs slowly over time. Acute renal failure can result from any condition that decreases the supply of blood to the kidneys, obstructs the flow of urine once it has left the kidneys, or causes injury to the kidneys. CRRT typically consists of a group of hemotherapies performed 24 hours a day in the intensive care unit. Baxter’s ACCURA and AQUARIUS machines are both specifically designed to provide all types of CRRT to patients.