Current Burden of End-stage Kidney Disease and Its Future Trend in China

Introduction: Understanding the status and trends of patients with ESKD is important to evaluate and predict its impact on the health care system in China.

Methods: Available publications and/or presentations from national and regional dialysis and transplantation registries were collected.

Results And Discussion: A national report in 1999 revealed that the prevalence and incidence of dialysis in China were 33.2 per million population (pmp) and 15.3 pmp, respectively. The numbers were updated to 237.3 pmp and 15.4 pmp in 2012. In big cities like Beijing and Shanghai, the numbers are much higher, with prevalence and incidence of 524.6 pmp and 107.3 pmp in Beijing in 2011, and 544.7 pmp and 82.9 pmp in Shanghai in 2011, respectively. The majority of patients received hemodialysis, accounting for 89.5% in 1999 and 89.1% in 2012. The increased prevalence of dialysis is partly due to increased affordability of dialysis; while affordability and accessibility still limit renal replacement therapy in China. Regarding causes of end-stage kidney disease in China, about half of the patients are diagnosed glomerulonephritis. The surge of hypertension and diabetes during the 1990s will probably have profound effects on prevalence and etiology of kidney disease in China.