Department of Medicine, Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, College of Medicine, Kaohsiung, Taiwan.
Nephrology (Carlton). 2010 Jun;15 Suppl 2:3-9. doi: 10.1111/j.1440-1797.2010.01304.x.
Chronic kidney disease (CKD) has emerged as a global public health burden. Taiwan has the highest incidence and prevalence rates of end-stage renal disease (ESRD) in the world. In this review, the following key issues of CKD in Taiwan are addressed: epidemiological data, underlying diseases patterns, risk factors, public health concerns and a preventive project. Prevalence of CKD are reported to be 6.9% for CKD stage 3-5, 9.83% for clinically recognized CKD and 11.9% for CKD stage 1-5. However, overall awareness of CKD is low, 9.7% for CKD stage 1-3 and 3.5% for stage 1-5. Diabetes mellitus (43.2%), chronic glomerulonephritis (25.1%), hypertension (8.3%) and chronic interstitial nephritis (2.8%) are four major underlying renal diseases of ESRD. Older age, diabetes, hypertension, smoking, obesity, regular use of herbal medicine, family members (both relatives and spouses), chronic lead exposure and hepatitis C are associated with higher risk for CKD. Impact of CKD increases risk of all-cause mortality and cardiovascular diseases, especially in those with overt proteinuria and advanced CKD stages. These impacts lead to increased medical costs. The nationwide CKD Preventive Project with multidisciplinary care program has proved its effectiveness in decreasing dialysis incidence, mortality and medical costs. It is crucially significant from Taiwan experience on CKD survey and preliminary outcome of the preventive project. Provision of a more comprehensive public health strategy and better care plan for CKD should be achieved by future international collaborative efforts and research.
慢性肾脏病 (CKD) 已成为全球公共卫生负担。台湾地区拥有世界上最高的终末期肾病 (ESRD) 发病率和流行率。在这篇综述中，探讨了台湾地区 CKD 的以下关键问题：流行病学数据、基础疾病模式、危险因素、公共卫生关注点和预防项目。报道称，CKD 3-5 期的患病率为 6.9%，临床诊断的 CKD 患病率为 9.83%，CKD 1-5 期的患病率为 11.9%。然而，CKD 的总体知晓率较低，CKD 1-3 期为 9.7%，CKD 1-5 期为 3.5%。糖尿病 (43.2%)、慢性肾小球肾炎 (25.1%)、高血压 (8.3%) 和慢性间质性肾炎 (2.8%) 是 ESRD 的四大基础肾脏疾病。年龄较大、糖尿病、高血压、吸烟、肥胖、经常使用草药、家族成员（包括亲属和配偶）、慢性铅暴露和丙型肝炎与 CKD 风险增加相关。CKD 的影响增加了全因死亡率和心血管疾病的风险，尤其是在有显性蛋白尿和晚期 CKD 阶段的患者中。这些影响导致医疗费用增加。全国性的 CKD 预防项目，结合多学科护理计划，已被证明可降低透析发病率、死亡率和医疗费用。从台湾地区 CKD 调查和预防项目的初步结果来看，这一点至关重要。未来的国际合作和研究应提供更全面的公共卫生策略和更好的 CKD 护理计划。
