SUMMARY POINTS

•  End stage renal disease (ESRD) is a life-threatening condition that results in most patients requiring a lifetime of high cost renal dialysis
•  Governments have grappled with the political, economic, and ethical challenges of providing treatment with their available budgets
•  This tension is more prominent in resource limited countries that have committed to universal health coverage
•  A systematic approach to inform universal renal dialysis policy can provide feasible, affordable, and scalable care
•  Providing peritoneal dialysis as first line of treatment is the most feasible option for low and middle income countries