Trends in the incidence and prevalence of end-stage kidney disease requiring dialysis in Taiwan: 2010-2018

Tai-Shuan Lai; Chih-Cheng Hsu; Ming-Huang Lin; Vin-Cent Wu; Yung-Ming Chen

doi:10.1016/j.jfma.2021.12.013

Trends in the incidence and prevalence of end-stage kidney disease requiring dialysis in Taiwan: 2010-2018

J Formos Med Assoc. 2022 Feb:121 Suppl 1:S5-S11. doi: 10.1016/j.jfma.2021.12.013. Epub 2022 Jan 22.

Authors

Tai-Shuan Lai¹, Chih-Cheng Hsu², Ming-Huang Lin³, Vin-Cent Wu⁴, Yung-Ming Chen⁵

Affiliations

¹ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: d99849016@ntu.edu.tw.
² Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan. Electronic address: cch@nhri.edu.tw.
³ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: clint424@nhri.edu.tw.
⁴ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: q91421028@ntu.edu.tw.
⁵ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: chenym@ntuh.gov.tw.

PMID: 35074236
DOI: 10.1016/j.jfma.2021.12.013

Abstract

Background/purpose: Taiwan has the highest incidence and prevalence of end-stage kidney disease (ESKD) worldwide. However, the epidemiologic features of ESKD requiring dialysis in Taiwan are unclear.

Methods: Our study population included all patients undergoing chronic dialysis (i.e., receiving dialysis treatment for at least three successive months) from the National Health Insurance Research Database from 2010 to 2018. Dialysis was defined using ICD-9-CM order codes for dialysis treatment. The age-standardized incidence and prevalence rates were calculated based on the World Health Organization standard population.

Results: The mean age was 47.7 ± 15.4 years at dialysis initiation. The incidence of ESKD requiring dialysis increased steadily during the study period, whereas the age-standardized incidence rate remained constant. The increased rate was particularly prevalent in men aged 65-74 and 75+ years. Additionally, the percentage of patients with estimated glomerular filtration rates > 10 mL/min/1.73 m² at dialysis inception increased during the study period, especially in persons aged 75+ years. Most patients chose hemodialysis as the initial dialysis modality, including 86.8% in 2010 and 90.6% in 2018. The prevalence of dialysis increased substantially between 2010 and 2018, whereas the age-standardized prevalence of dialysis remained stable. The increasing trend was especially prominent in men aged ≥ 65 years. Among the patients on dialysis, the proportion of patients with mean dialysis times of more than 10 years has been increasing.

Conclusion: The annual incidence and prevalence of dialysis increased steadily from 2010 to 2018, whereas the age-standardized incidence and prevalence of dialysis remained stable. The increased numbers of patients undergoing incident and prevalent dialysis were mostly elderly, especially men aged ≥65 years. Age-based prevention strategies and multidisciplinary care should be implemented to target the elderly population at risk of developing ESKD.

Keywords: Dialysis; Incidence; Prevalence; Trend.

MeSH terms

Adult
Aged
Humans
Incidence
Kidney Failure, Chronic* / epidemiology
Kidney Failure, Chronic* / therapy
Male
Middle Aged
Prevalence
Renal Dialysis*
Taiwan / epidemiology