The global dialysis market was valued at $69 billion in 2010, Fresenius Medical said in its latest annual report. Dialysis equipment and solutions total $11.7 billion. The products include dialyzers, dialysis machines, concentrates and dialysis solutions.

“The Indian market in Asia looks increasingly promising in the medium term,” Fresenius Medical said in the report, released in June. The Bad Homburg, Germany-based company had the largest share of the overall dialysis products market in 2010, at about 33 percent, followed by Baxter International Inc., of Deerfield, Illinois, and Gambro AB, of Stockholm.

“We expect the growing importance of the Chinese and Indian markets to accelerate our growth over the next few years,” the company said in the report. A spokesman didn't immediately respond to a request for comment.

Diabetes Epidemic

New Delhi-based Fortis plans to open 50 dialysis clinics, mostly in residential neighborhoods in cities and towns, over the next two years, said Varun Sethi, chief executive officer of the company's Renkare dialysis unit. The first opened in New Delhi's Greater Kailash neighborhood this month with seven booths, including a private suite.

Patients can watch television while tubes connected to their arm circulate blood through a dialysis machine. The service costs about 30,000 rupees ($570) a month for 12 visits, Sethi said.

Diabetes and high blood pressure are the main reasons for kidney failure. Excess blood-sugar causes the porous blood- filtering capillaries in the kidneys to clog and malfunction. End-stage renal disease is progressive and can't be reversed, meaning patients must receive routine dialysis or a new organ.

Eoin Treacy's view The global diabetes epidemic is a tragic side effect of improving median incomes and higher per capita calorie consumption. The expansion of the middle classes, particularly in China and India, is driving demand for healthcare of all types. Diabetes reflects the juncture of two important themes i.e. the increasing prevalence of a middle class disease combined with improving ability to pay for medication. (Also see Comment of the Day on November 21st 2011).

Fresenius Medical Care lost upward momentum somewhat from July but held the progression of rising major reaction lows following the August pullback and has subsequently rebounded impressively. A sustained move below €47.50 would be required to question potential for some additional upside.

Baxter International has been largely rangebound for the last three years and has exhibited a downward bias since August. It needs to sustain a move above $55 to begin to indicate demand is returning to dominance.