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Continuous Renal Replacement Therapy Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2032 - By Product, Technology, Grade, Application, End-user, Region: (North America, Europe, Asia Pacific, Latin America and Middle East and Africa)

Continuous Renal Replacement Therapy Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2032 - By Product, Technology, Grade, Application, End-user, Region: (North America, Europe, Asia Pacific, Latin America and Middle East and Africa)


The Continuous Renal Replacement Therapy (CRRT) market is poised for substantial expansion, fueled by the increasing burden of chronic kidney diseases and advancements in renal care technologies. C... もっと見る

 

 

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Summary

The Continuous Renal Replacement Therapy (CRRT) market is poised for substantial expansion, fueled by the increasing burden of chronic kidney diseases and advancements in renal care technologies. CRRT, primarily used in intensive care units, is becoming the preferred method for treating critically ill patients suffering from acute kidney injury (AKI) and other renal complications. Unlike conventional hemodialysis, CRRT offers a more gradual and continuous method of fluid and solute removal, making it suitable for hemodynamically unstable patients.

Market Insights

According to industry estimates, the global Continuous Renal Replacement Therapy market is expected to rise from US$ 1.65 Bn in 2025 to US$ 2.98 Bn by 2032, registering a compound annual growth rate (CAGR) of 8.81% during the forecast period. This growth can be attributed to the increasing prevalence of AKI, sepsis, and diabetes, particularly among aging populations who are more prone to critical illnesses. Additionally, the market is witnessing a transformation driven by technological innovations, such as automated systems, artificial intelligence integration, and advanced hemofiltration membranes.

Key Market Drivers

The surge in ICU admissions globally stands out as a primary driver of market growth. Acute kidney injury is a common complication in critical care settings, necessitating the adoption of CRRT systems. The rise in comorbid conditions such as diabetes, hypertension, and cardiovascular diseases has further amplified the need for renal replacement therapies. The elderly demographic, which often presents multiple health complications, also contributes significantly to the demand for CRRT.

Advancements in CRRT technologies are also playing a pivotal role. Leading manufacturers are introducing portable and automated systems that allow for continuous monitoring, precise fluid removal, and real-time data analytics. These systems are instrumental in enhancing patient safety and treatment efficacy, especially in intensive care environments.

Business Opportunities

One of the major opportunities lies in the development of pediatric-specific CRRT devices and improved biocompatible membranes. With increasing awareness about pediatric AKI cases, companies are focusing on creating customized solutions for this patient group. Another promising avenue is the integration of artificial intelligence to improve therapy precision and reduce clinician workload.

Emerging markets, particularly in the Asia Pacific and Latin America regions, present significant growth potential due to increasing healthcare investments, rising awareness, and the gradual modernization of healthcare infrastructure. Cost-effective CRRT solutions tailored to price-sensitive regions are likely to gain traction in these areas.

Regional Analysis

North America is projected to retain its leadership position in the global CRRT market. The region’s dominance is attributed to its advanced healthcare infrastructure, high incidence of renal diseases, and increasing ICU admissions among the elderly population. The presence of key industry players and proactive government initiatives to enhance awareness and treatment of kidney diseases further support the market's growth.

Europe follows closely, driven by a similar demographic trend and government-supported healthcare programs. Meanwhile, the Asia Pacific region is expected to witness the fastest growth rate, fueled by increasing healthcare accessibility, rising investments in hospital infrastructure, and a growing patient pool requiring critical care.

Key Players and Competitive Analysis

The CRRT market is characterized by the presence of several global and regional players focused on innovation, strategic collaborations, and product expansion. Key players include:

• Fresenius Medical Care – Known for its multiFiltratePRO platform, which integrates artificial intelligence for automated treatment adjustments.

• Baxter International Inc. – Offers the Prismaflex system, a widely adopted CRRT solution with flexible treatment options.

• Medtronic – Leveraging data analytics to improve treatment precision and reduce manual interventions.

• Nikkiso Co., Ltd. – Focusing on advanced filtration technologies to enhance therapeutic outcomes.

• Asahi Kasei Medical, B. Braun Melsungen AG, JMS Co., Ltd., Dialysis Systems, Thermo Fisher Scientific, and CytoSorbents Corporation are also prominent contributors shaping the competitive Analysis.

These companies are investing in research and development to enhance CRRT efficiency and safety while expanding their global reach through partnerships and acquisitions.

Emerging Trends

Several trends are reshaping the CRRT market. There is a growing emphasis on the development of AI-integrated devices that assist clinicians in monitoring and adjusting treatment parameters in real-time. Moreover, high-flux membrane technologies are improving the removal of larger molecules, including inflammatory mediators, thereby enhancing patient outcomes. The shift towards portable and user-friendly systems is another significant development, allowing broader usage across diverse healthcare settings.

Market Challenges

Despite promising growth prospects, the market faces certain challenges. Stringent regulatory frameworks across regions pose hurdles in product approval and commercialization. For example, devices approved in certain countries may not meet the regulatory criteria of major markets like the U.S. Furthermore, the high costs associated with CRRT equipment and consumables limit adoption in resource-constrained settings.

However, ongoing efforts to streamline approval processes and develop cost-effective systems are expected to mitigate these challenges. Government initiatives aimed at raising awareness and improving access to critical care treatments are also likely to support market growth.

Recent Developments

• In January 2023, Baxter announced a strategic restructuring plan, aiming to spin off its Renal Care and Acute Therapies units to enhance innovation and operational efficiency.

• In November 2023, Horizon Health Network introduced CRRT services at The Moncton Hospital in Canada, expanding critical care capabilities.

• In December 2023, Cheshire Medical Center, part of Dartmouth Health in the U.S., began offering CRRT for ICU patients, underscoring the growing adoption of these therapies across healthcare systems.

Conclusion

The global Continuous Renal Replacement Therapy market is entering a phase of dynamic growth, supported by increasing critical care needs, technological innovations, and expanding healthcare infrastructure in emerging economies. As the prevalence of kidney-related ailments continues to climb, the demand for efficient, flexible, and patient-centric CRRT solutions is expected to rise steadily. Strategic collaborations, regulatory harmonization, and the adoption of AI-driven systems will likely be key enablers of market expansion.

________________________________________

Market Segmentation

By Product

• System

• Consumables

By Modality

• Slow Continuous Ultra-Filtration (SCUF)

• Continuous Venovenous Hemofiltration (CVVH)

• Continuous Venovenous Hemodialysis (CVVHD)

• Continuous Venovenous Hemodiafiltration (CVVHDF)

By End User

• Hospitals

• Dialysis Clinics

• Ambulatory Surgical Centers

By Region

• North America

• Latin America

• Europe

• Asia Pacific

• Middle East and Africa

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Table of Contents

1. Executive Summary
1.1. Global Continuous Renal Replacement Therapy Market Snapshot
1.2. Future Projections
1.3. Key Market Trends
1.4. Regional Snapshot, by Value, 2025
1.5. Analyst Recommendations
2. Market Overview
2.1. Market Definitions and Segmentations
2.2. Market Dynamics
2.2.1. Drivers
2.2.2. Restraints
2.2.3. Market Opportunities
2.3. Value Chain Analysis
2.4. Porter’s Five Forces Analysis
2.5. COVID-19 Impact Analysis
2.5.1. Supply
2.5.2. Demand
2.6. Economic Overview
2.6.1. World Economic Projections
2.7. PESTLE Analysis
3. Global Continuous Renal Replacement Therapy Market Outlook, 2019-2032
3.1. Global Continuous Renal Replacement Therapy Market Outlook, by Product, Value (US$ Bn), 2019-2032
3.1.1. Key Highlights
3.1.1.1. System
3.1.1.2. Consumables
3.2. Global Continuous Renal Replacement Therapy Market Outlook, by Modality, Value (US$ Bn), 2019-2032
3.2.1. Key Highlights
3.2.1.1. Slow Continuous Ultra-Filtration (SCUF)
3.2.1.2. Continuous Venovenous Hemofiltration (CVVH)
3.2.1.3. Continuous Venovenous Hemodialysis (CVVHD)
3.2.1.4. Continuous Venovenous Hemodiafiltration (CVVHDF)
3.3. Global Continuous Renal Replacement Therapy Market Outlook, by End User, Value (US$ Bn), 2019-2032
3.3.1. Key Highlights
3.3.1.1. Hospitals
3.3.1.2. Dialysis Clinics
3.3.1.3. Ambulatory Surgical Centers
3.4. Global Continuous Renal Replacement Therapy Market Outlook, by Region, Value (US$ Bn), 2019-2032
3.4.1. Key Highlights
3.4.1.1. North America
3.4.1.2. Europe
3.4.1.3. Asia Pacific
3.4.1.4. Latin America
3.4.1.5. Middle East & Africa
4. North America Continuous Renal Replacement Therapy Market Outlook, 2019-2032
4.1. North America Continuous Renal Replacement Therapy Market Outlook, by Product, Value (US$ Bn), 2019-2032
4.1.1. Key Highlights
4.1.1.1. System
4.1.1.2. Consumables
4.2. North America Continuous Renal Replacement Therapy Market Outlook, by Modality, Value (US$ Bn), 2019-2032
4.2.1. Key Highlights
4.2.1.1. Slow Continuous Ultra-Filtration (SCUF)
4.2.1.2. Continuous Venovenous Hemofiltration (CVVH)
4.2.1.3. Continuous Venovenous Hemodialysis (CVVHD)
4.2.1.4. Continuous Venovenous Hemodiafiltration (CVVHDF)
4.3. North America Continuous Renal Replacement Therapy Market Outlook, by End User, Value (US$ Bn), 2019-2032
4.3.1. Key Highlights
4.3.1.1. Hospitals
4.3.1.2. Dialysis Clinics
4.3.1.3. Ambulatory Surgical Centers
4.3.2. BPS Analysis/Market Attractiveness Analysis
4.4. North America Continuous Renal Replacement Therapy Market Outlook, by Country, Value (US$ Bn), 2019-2032
4.4.1. Key Highlights
4.4.1.1. U.S. Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
4.4.1.2. U.S. Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
4.4.1.3. U.S. Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
4.4.1.4. Canada Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
4.4.1.5. Canada Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
4.4.1.6. Canada Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
5. Europe Continuous Renal Replacement Therapy Market Outlook, 2019-2032
5.1. Europe Continuous Renal Replacement Therapy Market Outlook, by Product, Value (US$ Bn), 2019-2032
5.1.1. Key Highlights
5.1.1.1. System
5.1.1.2. Consumables
5.2. Europe Continuous Renal Replacement Therapy Market Outlook, by Modality, Value (US$ Bn), 2019-2032
5.2.1. Key Highlights
5.2.1.1. Slow Continuous Ultra-Filtration (SCUF)
5.2.1.2. Continuous Venovenous Hemofiltration (CVVH)
5.2.1.3. Continuous Venovenous Hemodialysis (CVVHD)
5.2.1.4. Continuous Venovenous Hemodiafiltration (CVVHDF)
5.3. Europe Continuous Renal Replacement Therapy Market Outlook, by End User, Value (US$ Bn), 2019-2032
5.3.1. Key Highlights
5.3.1.1. Hospitals
5.3.1.2. Dialysis Clinics
5.3.1.3. Ambulatory Surgical Centers
5.3.2. BPS Analysis/Market Attractiveness Analysis
5.4. Europe Continuous Renal Replacement Therapy Market Outlook, by Country, Value (US$ Bn), 2019-2032
5.4.1. Key Highlights
5.4.1.1. Germany Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
5.4.1.2. Germany Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
5.4.1.3. Germany Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
5.4.1.4. U.K. Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
5.4.1.5. U.K. Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
5.4.1.6. U.K. Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
5.4.1.7. France Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
5.4.1.8. France Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
5.4.1.9. France Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
5.4.1.10. Italy Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
5.4.1.11. Italy Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
5.4.1.12. Italy Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
5.4.1.13. Turkey Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
5.4.1.14. Turkey Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
5.4.1.15. Turkey Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
5.4.1.16. Russia Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
5.4.1.17. Russia Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
5.4.1.18. Russia Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
5.4.1.19. Rest of Europe Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
5.4.1.20. Rest of Europe Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
5.4.1.21. Rest of Europe Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
6. Asia Pacific Continuous Renal Replacement Therapy Market Outlook, 2019-2032
6.1. Asia Pacific Continuous Renal Replacement Therapy Market Outlook, by Product, Value (US$ Bn), 2019-2032
6.1.1. Key Highlights
6.1.1.1. System
6.1.1.2. Consumables
6.2. Asia Pacific Continuous Renal Replacement Therapy Market Outlook, by Modality, Value (US$ Bn), 2019-2032
6.2.1. Key Highlights
6.2.1.1. Slow Continuous Ultra-Filtration (SCUF)
6.2.1.2. Continuous Venovenous Hemofiltration (CVVH)
6.2.1.3. Continuous Venovenous Hemodialysis (CVVHD)
6.2.1.4. Continuous Venovenous Hemodiafiltration (CVVHDF)
6.3. Asia Pacific Continuous Renal Replacement Therapy Market Outlook, by End User, Value (US$ Bn), 2019-2032
6.3.1. Key Highlights
6.3.1.1. Hospitals
6.3.1.2. Dialysis Clinics
6.3.1.3. Ambulatory Surgical Centers
6.3.2. BPS Analysis/Market Attractiveness Analysis
6.4. Asia Pacific Continuous Renal Replacement Therapy Market Outlook, by Country, Value (US$ Bn), 2019-2032
6.4.1. Key Highlights
6.4.1.1. China Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
6.4.1.2. China Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
6.4.1.3. China Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
6.4.1.4. Japan Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
6.4.1.5. Japan Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
6.4.1.6. Japan Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
6.4.1.7. South Korea Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
6.4.1.8. South Korea Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
6.4.1.9. South Korea Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
6.4.1.10. India Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
6.4.1.11. India Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
6.4.1.12. India Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
6.4.1.13. Southeast Asia Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
6.4.1.14. Southeast Asia Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
6.4.1.15. Southeast Asia Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
6.4.1.16. Rest of Asia Pacific Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
6.4.1.17. Rest of Asia Pacific Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
6.4.1.18. Rest of Asia Pacific Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
7. Latin America Continuous Renal Replacement Therapy Market Outlook, 2019-2032
7.1. Latin America Continuous Renal Replacement Therapy Market Outlook, by Product, Value (US$ Bn), 2019-2032
7.1.1. Key Highlights
7.1.1.1. System
7.1.1.2. Consumables
7.2. Latin America Continuous Renal Replacement Therapy Market Outlook, by Modality, Value (US$ Bn), 2019-2032
7.2.1. Key Highlights
7.2.1.1. Slow Continuous Ultra-Filtration (SCUF)
7.2.1.2. Continuous Venovenous Hemofiltration (CVVH)
7.2.1.3. Continuous Venovenous Hemodialysis (CVVHD)
7.2.1.4. Continuous Venovenous Hemodiafiltration (CVVHDF)
7.3. Latin America Continuous Renal Replacement Therapy Market Outlook, by End User, Value (US$ Bn), 2019-2032
7.3.1. Key Highlights
7.3.1.1. Hospitals
7.3.1.2. Dialysis Clinics
7.3.1.3. Ambulatory Surgical Centers
7.3.2. BPS Analysis/Market Attractiveness Analysis
7.4. Latin America Continuous Renal Replacement Therapy Market Outlook, by Country, Value (US$ Bn), 2019-2032
7.4.1. Key Highlights
7.4.1.1. Brazil Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
7.4.1.2. Brazil Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
7.4.1.3. Brazil Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
7.4.1.4. Mexico Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
7.4.1.5. Mexico Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
7.4.1.6. Mexico Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
7.4.1.7. Argentina Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
7.4.1.8. Argentina Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
7.4.1.9. Argentina Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
7.4.1.10. Rest of Latin America Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
7.4.1.11. Rest of Latin America Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
7.4.1.12. Rest of Latin America Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
8. Middle East & Africa Continuous Renal Replacement Therapy Market Outlook, 2019-2032
8.1. Middle East & Africa Continuous Renal Replacement Therapy Market Outlook, by Product, Value (US$ Bn), 2019-2032
8.1.1. Key Highlights
8.1.1.1. System
8.1.1.2. Consumables
8.2. Middle East & Africa Continuous Renal Replacement Therapy Market Outlook, by Modality, Value (US$ Bn), 2019-2032
8.2.1. Key Highlights
8.2.1.1. Slow Continuous Ultra-Filtration (SCUF)
8.2.1.2. Continuous Venovenous Hemofiltration (CVVH)
8.2.1.3. Continuous Venovenous Hemodialysis (CVVHD)
8.2.1.4. Continuous Venovenous Hemodiafiltration (CVVHDF)
8.3. Middle East & Africa Continuous Renal Replacement Therapy Market Outlook, by End User, Value (US$ Bn), 2019-2032
8.3.1. Key Highlights
8.3.1.1. Hospitals
8.3.1.2. Dialysis Clinics
8.3.1.3. Ambulatory Surgical Centers
8.3.2. BPS Analysis/Market Attractiveness Analysis
8.4. Middle East & Africa Continuous Renal Replacement Therapy Market Outlook, by Country, Value (US$ Bn), 2019-2032
8.4.1. Key Highlights
8.4.1.1. GCC Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
8.4.1.2. GCC Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
8.4.1.3. GCC Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
8.4.1.4. South Africa Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
8.4.1.5. South Africa Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
8.4.1.6. South Africa Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
8.4.1.7. Egypt Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
8.4.1.8. Egypt Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
8.4.1.9. Egypt Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
8.4.1.10. Nigeria Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
8.4.1.11. Nigeria Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
8.4.1.12. Nigeria Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
8.4.1.13. Rest of Middle East & Africa Continuous Renal Replacement Therapy Market by Product, Value (US$ Bn), 2019-2032
8.4.1.14. Rest of Middle East & Africa Continuous Renal Replacement Therapy Market by Modality, Value (US$ Bn), 2019-2032
8.4.1.15. Rest of Middle East & Africa Continuous Renal Replacement Therapy Market by End User, Value (US$ Bn), 2019-2032
9. Competitive Landscape
9.1. Company Market Share Analysis, 2025
9.2. Competitive Dashboard
9.3. Company Profiles
9.3.1. Fresenius Medical Care
9.3.1.1. Company Overview
9.3.1.2. Type Portfolio
9.3.1.3. Financial Overview
9.3.1.4. Business Strategies and Development
9.3.2. B. Braun Melsungen AG
9.3.3. Kawasaki Medical
9.3.4. Medtronic
9.3.5. Asahi Kasei Medical
9.3.6. Nikkiso Co., Ltd.
9.3.7. JMS Co., Ltd.
9.3.8. Dialysis Systems
9.3.9. Thermo Fisher Scientific
9.3.10. CytoSorbents Corporation
9.3.11. Others
10. Appendix
10.1. Research Methodology
10.2. Report Assumptions
10.3. Acronyms and Abbreviations

 

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