Continuous Renal Replacement Therapy (CRRT) Market Size, Share & COVID-19 Impact Analysis, By Product Type (Systems, and Consumables), By Modality (Slow continuous ultra-filtration {SCUF}, Continuous Venovenous Hemofiltration {CVVH}, Continuous Venovenous Hemodialysis {CVVHD}, and Continuous Venovenous Hemodiafiltration {CVVHDF), and Regional Forecast, 2020-2027

The global continuous renal replacement therapy (CRRT) market size was valued at USD 986.4 million in 2019 and is projected to reach USD 1,811.5 million by 2027, exhibiting a CAGR of 8.0% during the forecast period.

Continuous renal replacement therapy (CRRT) is a popular choice of therapy usually used for renal support in critically ill patients with acute kidney injury (AKI), mainly in hemodynamically unstable patients. It includes the solute removal from blood through the process of hemodialysis or hemofiltration or a combination of both methods. The CRRT therapy is generally carried for about 24 hours in an ICU, making it different from other kinds of conventional renal replacement therapies such as intermittent hemodialysis (IHD) that lasts for about 4 to 6 hours or even less.

For improved dialysis care, key strategies such as technological advancement are adopted by major acute therapy manufacturers. For Example, in 2019, Baxter international Inc., cleared its PrisMax system and the integrated TherMax blood warmer for Continuous renal replacement therapy and therapeutic plasma exchange (TPE). Factors such as the growing prevalence of acute kidney injury worldwide, rising incidence of sepsis, a mounting number of ICU patients, and significant technological advancements would boost the market.

However, stringent regulatory guidelines, coupled with the high CRRT procedural cost in North America, is likely to hamper the market growth. But, the FDA has regulated specific laws on manufacturers that certify the accessibility of advanced quality CRRT devices in intensive care units, thus creating growth opportunities for CRRT industry in the near future.

Impact of COVID-19 Pandemic on the CRRT Market

Despite the COVID-19 outbreak challenges, the market for Continuous renal replacement therapy has witnessed a rise in financial incentives and regulatory supports from various governments worldwide. The market continues to progress and develop in terms of the number of products, companies, and applications. Among the COVID-19 infected people, quite a few have developed acute kidney injury (AKI), a condition which can upsurge mortality. For example, according to the recent report by the International Society of Nephrology (ISN), about 25-50% of the people infected with COVID-19, were diagnosed with kidney abnormalities. Although it is generally observed that COVID-19 virus involves respiratory systems mainly lungs, but a research study and evidence shows that it also includes the kidneys infections either directly or intervened by excessive immune response seen in severe COVID-19 patients.

Besides, as per previous reports of SARS and MERS-CoV infections, acute kidney injury (AKI) has developed in 5 to 15 per cent cases and it brings very high mortality. Considering the ongoing scenario and the increasing rate of kidney infections due to COVID-19, such extra-corporeal therapies may play an important role in the treatment of severely ill patients. Moreover, to support this Ministry of Health & Family Welfare (Government of India) in 2020, released guidelines for dialysis in COVID-19 patients. Right treatment by the experts at the right time can save the lives of the infected people who are battling between life and death. Thus, the aforementioned factors contribute to the positive growth of CRRT market during the forecast period.

LATEST TRENDS

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Technological Advancements in the Market to Boost Kidney Disease Management

The use of CRRT for the management of AKI in critically ill patients has significantly benefited from technological advances in equipment design, a developed understanding of the dose of RRT, timing, and the application of new, more complex modalities. Such advancements have momentously expanded the field of extracorporeal therapies in the ICU. Furthermore, software integration is likely to become a new tool for advanced equipment to perform CRRT treatments efficiently and more safely. The treatment delivery and online hemodynamic stability will be affected by integrating bioimpedance and online hematocrit measurements. Integrating thermal energy balance will help in monitoring the patient's blood temperature. This allows a specific energy balance to be achieved by altering the dialysate based on temperature sensors placed on blood and dialysate lines.

Indeed, such integrated care must be supported by information technologies, for integrated assistance, data collection, delivery of a personalized recommendation, and measurement of results. Consequently, the implementation of advanced software solutions will help in improving treatment for acute kidney injury and organ dysfunction in critically ill patients.

DRIVING FACTORS

Increasing Incidence of Acute Kidney Injury and Chronic Kidney Disease is driving the Market

Diabetes, hypertension, and aging population are the primary risk factors for acute kidney injury. Globally, the prevalence of diabetes is increasing at a rapid pace. According to an article published by the International Diabetes Federation (DFU) in 2019, an estimated 463 million people were living with diabetes, and the number is expected to rise to 578 million by 2030. Accordingly, with the increase in the incidences of diabetes, the number of patients with acute kidney injury is also increasing. Rising awareness by health care providers might reduce its occurrence and improve the management of the underlying diseases amongst the aged population.

Moreover, according to the Centers for Disease Control and Prevention (CDC) in 2019, around 37 million people in U.S are estimated to have chronic kidney disease. This disease, if left untreated, may lead to renal failure or kidney injury and can also result in end-stage renal disease, thereby leading to rise in demand for renal replacement therapy. Hence, the growing prevalence of acute and chronic kidney diseases is likely to propel the growth of the Market.

Growing R&D Expenditures by Industry Players for Developing Innovative CRRT Devices to Boost the Market Growth

The investments in research and development activities by prominent industry players, such as Baxter International Inc., Fresenius Kabi, and Medtronic, aimed at improving CRRT systems are driven to impact business growth. For example, Baxter has developed the PRISMAFLEX system for critical care. PRISMAFLEX system is a flexible platform that offers customized therapies according to the patient's ease and suitability. The system is integrated with advanced technology that enables accurate CRRT in patients suffering from acute kidney injuries. Besides this, the Diapact CRRT system developed by B. Braun is unified with advanced technology that allows effective treatment of acute kidney injuries and diseases. The critical blood filtration process is carried out precisely without any obstructions ensuring rapid recovery of the patients. Such improvements in the CRRT systems, coupled with innovation will result in higher adoption of CRRT systems and is likely to amplify the growth in the near future.

RESTRAINING FACTORS

Stringent Regulatory Guidelines for CRRT in North America to Hinder the Market Growth

Continuous renal replacement therapy product companies in North America experience several regulatory barriers owing to complex regulations set by the FDA, thus adversely impacting the demand for these products. For example, in Europe, CRRT is approved for several indications such as cardiac failure, liver support, intoxication, elevated Intracranial Pressure (ICP), rhabdomyolysis, and post-cardiac surgery. On the other hand, in North America, no CRRT machine is approved by the FDA for the treatment of multiple indications. Likewise, no anticoagulating agent for blood infusion during a CRRT procedure is approved by the FDA till date, though it has been approved in Europe. Owing to these stringent regulatory barriers, several CRRT products approved in other countries are yet to receive approval from the FDA in North America.

The U.S. is holding a substantial Continuous Renal Replacement Therapy Market share in the global market due to its huge AKI population base. Accordingly, the presence of stringent and regulatory policies for the approval of new CRRT product launches in this region is hampering the growth of the market.

SEGMENTATION

By Product Type Analysis

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Consumables Segment to Dominate the CRRT Market Owing to its Low Cost

Based on type, the continuous renal replacement therapy (CRRT) market is segmented into systems and consumables. Though consumable products are low-priced due to repeated use, the market for this segment is comparatively the largest. Besides this, the consumables segment market is predicted to grow massively during the forecast period, owing to the increasing application of charcoal filters, hemofilter, fluids, and other consumables in CRRT procedures.

The systems segment is likely to grow moderately, owing to an increase in the prevalence of acute kidney injury cases. According to an article published by the National Center for Biotechnology Information, the prevalence of acute kidney injury treated with CRRT is approximately 200-300 per million people per year, worldwide. Henceforth, with the increasing prevalence of acute kidney injury, the use of these systems will grow continually.

By Modality Analysis

CVVH to Dominate Owing to the Rising Cases of Fluid Overload in AKI Patients.

Based on modality, the market is segmented into slow continuous ultra-filtration (SCUF), continuous venovenous hemofiltration (CVVH), continuous venovenous hemodialysis (CVVHD), and continuous venovenous hemodiafiltration (CVVHDF). Among them, the continuous venovenous hemofiltration (CVVH) segment is predicted to dominate the market. The dominance is attributable to the growing incidence of fluid overload cases, which is recurrently found in patients affected by acute kidney injury in critical care units. Additionally, according to an article issued by Elsevier, congestive heart failure is responsible for approximately 5% of all-cause mortality in dialysis patients, which is linked closely with fluid overload, and will consequently increase the application of CVVH treatment procedure. Thus, the increase in dialysis procedures are driving the growth of the segment.

The continuous venovenous hemodiafiltration (CVVHDF) segment is estimated to grow at the highest rate during the forecast period. This treatment modality results in comprehensive removal and replacement of solutes and fluids within the blood. It also includes principles of diffusion and convection, i.e., hemofiltration and hemodialysis using a competent hemodiafilter to remove both solute and fluid, hence propelling the growth of the market.

REGIONAL INSIGHTS

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Growing Demand for CRRT Procedures and Upsurge in Kidney Diseases to Aid North America ‘s Dominance

The continuous renal replacement therapy market in North America generated a revenue of USD 354.3 million in 2019. The growing demand for CRRT procedures and radical innovation of the machines and systems are factors responsible for the growth of this market in North America.  Besides this, the growing prevalence of kidney diseases in the U.S. is projected to spur market growth over the forecast period. According to the data published by the Centers for Disease Control and Prevention (CDC), in 2020, about 34.2 million people in the U.S. are diagnosed with diabetes. Thus, it proposes a large base of kidney-affected target populace for the CRRT market in this region.

On the other hand, Asia Pacific is expected to showcase the fastest growth during the forecast period on account of technological advancement and substantial healthcare expenditure. Moreover, the governments of several Asian countries are actively investing on improving the healthcare centers and services for providing better healthcare facilities to its patient population. Hence, all the aforementioned dynamics are expected to foster growth of this region.

KEY INDUSTRY PLAYERS

Innovation and Geographical Expansion of Key Players to Assist Market Growth

The competitive landscape of the global market represents a monopolistic nature as it is dominated by Baxter International Inc. The presence of a diversified product portfolio of unique Continuous renal replacement therapy technology in critical care, along with constant innovations by the company leading to new device introductions, is the key factor responsible for the dominance of this company.

However, the regional and domestic players such as B. Braun Melsungen AG, Fresenius Medical Care AG & Co. KGaA, Asahi Kasei Corporation, NxStage Medical, Inc., Toray Medical Co., NIPRO Corporation, Ltd, Medtronic plc, and others have entered the market with innovative technology devices. They are focusing on making a positive impact on the market, thereby gaining a significant position in the market share.

LIST OF KEY COMPANIES PROFILED:

• Baxter International Inc. (Illinois, United States)


• B. Braun Medical Inc.  (Pennsylvania, United States)


• Fresenius Medical Care AG & Co. KGaA (Bad Homburg, Germany)


• Asahi Kasei Corporation (Tokyo, Japan)


• NIPRO Corporation (Osaka, Japan)


• Toray Medical Co., Ltd (Tokyo, Japan)


• NxStage Medical, Inc., (Massachusetts, United States)


• Medtronic Plc


• Other key Players

KEY INDUSTRY DEVELOPMENTS:

• April 2020 – FDA Grants Marketing of New Device for Continuous Dialysis Therapy for use in Pediatric Patients with Certain Kidney Conditions. The CARPEDIEM System is the first CRRT device intended for a lower weight-specific pediatric patient population who have a sudden or temporary loss of kidney function (acute kidney injury) or have excessive water in their bodies because their kidneys are not functioning properly (fluid overload).


• February 2019 – Fresenius Medical Care announced its acquisition of NxStage Medical following the approval by antitrust authorities in the United States. With the help of this acquisition, Fresenius Medical Care is enabled to leverage its supply chain, manufacturing, and marketing competencies across the dialysis products, services, and care coordination businesses in a less labor- and capital-intensive care setting.

REPORT COVERAGE

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The Continuous renal replacement therapy market research report provides a detailed analysis of the market and focuses on key aspects such as leading companies, product types, and leading modality types. Besides this, the report offers insights into the market, current trends and highlights the key industry developments. In addition to the aforementioned factors, the report encompasses several factors that have contributed to the growth of the market over recent years.

Report Scope & Segmentation