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