Current burden and probable increasing incidence of ESRD in China

Aims: To illustrate the incidence and prevalence of ESRD in mainland China, and estimate future trends. Materials and methods: The Chinese Society of Blood Purification (CSBP) produced a survey form. The form was designed for use at the facility level, rather than at the patient level. The data were those prevailing at the end of 2008, i.e., the total number of patients at the end of 2007 and the number of new patients during the year 2008; numbers of males and females and each of the age groups; numbers of diabetes, hypertension, polycystic kidney disease, chronic interstitial nephritis, etc. as primary cause of ESRD; and numbers of cardiovascular disease, stroke, infection, etc. as primary cause of death. The forms were distributed to each dialysis facility, and returned to CSBP for analysis. The point prevalence of ESRD patients on maintenance hemodialysis (MHD) at the end of 2007 and 2008, and the annual incidence in 2008 were calculated. The primary cause of ESRD and primary cause of death were also reported. Results: Among 31 provinces and/or regions, 27 responded. At the end of 2007, there were totally 65,074 ESRD patients on MHD or PD; the point prevalence was estimated to be 51.7 per million population (pmp) around mainland China. The number increased to 102,863 at the end of 2008; point prevalence increased to 79.1 pmp. The annual increasing rate of prevalence was 52.9%. The number of new ESRD patients was 45,423; the annual incidence was 36.1 pmp in the year 2008. The main causes of ESRD were glomerulonephritis (45%), diabetes (19%), hypertension (13%), polycystic kidney disease (2%) and others or unknown (20%). The main cause of death was cardiovascular (31.0%), stroke (20.3%), infection (19.9%) and others (28.8%). Conclusions: Although the prevalence was relatively low compared with other Asian regions, the incidence of MHD was high. Mainland China is anticipating an increasing burden of ESRD in the near future.