By now, dialysis companies like DaVita and Fresenius know very well where to build their dialysis units. Here’s where:
1. wherever African Americans live: African Americans go on dialysis 3-5 times more than whites.
2. wherever Hispanics live: Hispanics go on dialysis 3 times more than whites. 25% of Mexicans have diabetes, and 45% of diabetics go on dialysis (http://www.voxxi.com/making-the-world-dialysis-free-2020/)
3. wherever American Indians live: Amerindians have the same “thrifty genotype” as Mexicans and Pacific Islanders (http://thejetnewspaper.com/2012/12/07/dialysis-in-fiji-an-easily-preventable-epidemic/). This “thrifty genotype” was an excellent thing. It kept people alive during the tens of thousands of years that they had to survive starvation. Now that people are couch potatoes who eat take-out from McDonald’s, the “thrifty genotype” is causing diabetes in half the population. There are many more dialysis units being built on Indian reservations than casinos.
4. wherever the elderly live: the fastest growing population segment on dialysis today are the elderly. That’s because even the healthiest ones start out in Stage II chronic kidney disease, just by virtue of their age. It takes very little to tip them over into a higher stage of kidney failure–too much of a water pill, too little water intake (the elderly have decreased thirst), etc. There are already 2 dialysis units in Leesburg, where I practice. There will soon be dozens around The Villages, a few minutes north of Leesburg, with its 90,000 retirees.