Prodjosudjadi Wiguno, Suhardjono A
Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine University of Indonesia, Jakarta, Indonesia.
Ethn Dis. 2009 Spring;19(1 Suppl 1):S1-33-6.
The number of cases of chronic kidney disease is growing rapidly, especially in the developing world. At a certain level of renal function, progression of chronic kidney disease to endstage renal disease (ESRD) is inevitable. ESRD has become a major health problem because it is a devastating medical condition, and the cost of treatment is a huge economic burden. This article presents data collected from 13 nephrology centers in response to specifically designed questionnaires. These centers were divided into 7 groups on the basis of geographic location. Previous data had given the impression that the incidence and prevalence of ESRD had increased, and the results of this study support these previous data. Since a national registry of ESRD has just been developed for Indonesia and we can present only limited data in this study, the numbers in this article underestimate the true incidence and prevalence rates. Although hemodialysis facilities have been developed rapidly, further development is still required. Continuous ambulatory peritoneal dialysis as an alternative renal replacement therapy (RRT) is only now being introduced. Kidney transplantation programs expand very slowly. RRT still imposes a high cost of treatment for ESRD; therefore, these treatments are unaffordable for most patients. Recently, government health insurance has covered financially strained families requiring RRT. Since the cost of RRT for ESRD has significantly increased over time, the management approach should be shifted from treatment to prevention.
慢性肾脏病病例数正在迅速增长，尤其是在发展中世界。在一定的肾功能水平下，慢性肾脏病进展至终末期肾病（ESRD）是不可避免的。ESRD已成为一个主要的健康问题，因为它是一种极具破坏性的病症，而且治疗费用是巨大的经济负担。本文展示了从13个肾脏病中心针对专门设计的问卷收集的数据。这些中心根据地理位置分为7组。先前的数据给人的印象是ESRD的发病率和患病率有所上升，本研究结果支持这些先前的数据。由于印度尼西亚刚刚建立了ESRD国家登记处，且我们在本研究中只能提供有限的数据，因此本文中的数字低估了真实的发病率和患病率。尽管血液透析设施发展迅速，但仍需要进一步发展。持续非卧床腹膜透析作为一种替代肾脏替代疗法（RRT），目前才刚刚引入。肾脏移植项目发展非常缓慢。RRT仍然给ESRD带来高昂的治疗费用；因此，这些治疗对大多数患者来说难以承受。最近，政府医疗保险已覆盖了需要RRT的经济困难家庭。由于ESRD的RRT费用随着时间显著增加，管理方法应从治疗转向预防。
