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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