The article addresses the growing demand for dialysis, which represents a key challenge for universal health coverage systems. The main challenge is not only to expand access to treatment for kidney failure, but also to maintain equitable and high-quality care. The author argues that the long-term viability of systems depends primarily on their architecture and layout, not on the choice of a particular type of treatment. The article emphasizes the need to create such healthcare systems that will be able to consistently provide quality services for patients with kidney failure regardless of financial or social barriers.