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12.9-15.1%

7.2-13.7%

3.2-11.3%

10.2%

4.2%

8.45-16.3%

13.1%

Prevention Project

ِAim of the Prevention Project is to promote :

  • The screening of high-risk populations
  • Patient Education
  • Multidisciplinary team care

Taiwan

During (1997 - 2003)

6.9%

9.8%

Intensive urinary screening program was also conducted for the family members of patients with ESRD under the project.

11.9%

1.0%

3.8%

6.8%

0.2%

0.1%

Awareness Of CKD

Multidisciplinary pre-dialysis education (MPE) program

Multidisciplinary pre-ESRD care

lower overall mortality

reduced incidence of dialysis

reduced medical costs for dialysis period and during total observation period

Prevalence (11.9%)

awareness

(3.5%)

Low awareness may be due to :

Low socioeconomic and educational status.

Promoting

Awareness of CKD

Chronic

Kidney

Disease

in Taiwan

  • Mohamed El-Assy
  • Mervat El-Sangedy
  • Dana Shaker
  • Mohamed El-Sergany
  • Yasser Hamdy
  • Nihal Sharaf El-Din
  • ِAhmed Mohsen
  • Moustafa El-Khatib
  • Mohamed Ghorap
  • Fattma El-Kayal
  • Dalia Yehia
  • Mohamed Saad

Impacts of CKD

on public health

The increased medical expenses

Poor prognosis of high mortality and morbidity

• Patients with CKD have 83% higher mortality for all-cause and 100% higher for cardiovascular diseases.

Taiwan has the highest incidence and prevalence rates of end-stage renal disease (ESRD)

• Even in subjects with CDK stage 1-2, hazard ratios (HR) for all-cause mortality were still significantly higher in:

 - Those with overt proteinuria

 - Elderly population with CKD

High incidence and prevalence

of ESRD in Taiwan:

current status and why

Taiwan has the highest incidence and prevalence rate of the ESRD as from 1990 to 2001, incidence and prevalence rate in the ESRD patients increased 2.6 times from 126 to 331/million populations and 3.46 times from 382 to 1322 / pmp respectively.

In 2007, there were 48072 haemodialysis and 4465 peritoneal cases. Moreover, the domestic renal transplant patients from 1997 to 2007 were 2054 cases and it was estimated that another 50% of patients received offshore renal transplantation, mainly from china.

Possible explanations:

First: launching of the NHI in 1995 provided free coverage for dialysis therapy, which facilitates the utilization of renal replacement therapy.

Second: the better health care system may improve the survival rate and increase overall life expectancy.

Primary Renal Diseases of ESRD

Major Underlying renal diseases of ESRD in 2007:

Challenges in EGFR measurement and diagnosis of CKD

Hypertension

(8.3%)

Diabetes Mellitus

(43.2%)

Well-Established Risk Factors for CKD

More Potential Risk Factors for CKD

Old Age

Chinese Herbal Drugs

Smoking

Hypertension

Hepatitis

Lead Intoxication

Chronic interstitial nephritis

(2.8%)

Chronic Glomerulonephritis

(25.1%)

Diabetes

Obesity

Being Female

Prevalence of CKD among different areas could be influenced by many factors:

Family History

Hyperlipedemia

Metabolic Syndrome

study population

ُEthnicities of different races

Method of creatinine measurement

Jaffe or enzymatic method and with or without standardization

The difference in

survey design

ٍٍٍStages of CKD

Equation formula for

GFR calculation

Purposed

Random

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