Prevention Project
ِAim of the Prevention Project is to promote :
- The screening of high-risk populations
- Patient Education
- Multidisciplinary team care
Taiwan
Intensive urinary screening program was also conducted for the family members of patients with ESRD under the project.
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