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Section 1: CKD Epidemiology

Section 1: CKD Epidemiology. The Problem. Chronic Kidney Disease is an epidemic worldwide Growth 6-8% per annum of dialysis patients Accumulating data re: possibility of delaying the progression of kidney disease, using multiple drug and behaviour intervention therapies.

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Section 1: CKD Epidemiology

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  1. Section 1: CKD Epidemiology

  2. The Problem • Chronic Kidney Disease is an epidemic worldwide • Growth 6-8% per annum of dialysis patients • Accumulating data re: possibility of delaying the progression of kidney disease, using multiple drug and behaviour intervention therapies. • Under-recognition at earlier stages of kidney dysfunction persists • Late referral • Lost opportunities for improved patient outcomes

  3. RRT Modalities 36,542 DOD/0503-04

  4. 300 250 0 - 44 45 - 64 200 65+ Age Specific Rate per Million Diabetics 150 Total 100 50 0 93 85 86 87 88 90 91 92 94 95 99 96 80 81 82 83 84 97 98 2000 2001 Year Patients Accepted in the UK for Renal Replacement Therapy

  5. Cadaveric Kidney Donors & Transplants and End of Year Kidney Waiting List, UK, 1994-2003 DOD/0503-04

  6. Prevalence of renal replacement therapy

  7. Estimates of Prevalence of CKD in the US: NHANES III Adapted from Am J Kidney Dis 2002; 39 (2, Suppl. 1): S17-S31

  8. NICE: 2008 Classification of CKDwaking up to the impact of proteinuria • Stage 1: GFR>90 + abnormal urinalysis • Stage 2: GFR 60-89 + abnormal urinalysis • Stage 3A: GFR 45-59 • Stage 3B: GFR 30-44 • Stage 4: GFR 15-29 • Stage 5: GFR <15 or dialysis dependent Suffix P denotes presence of proteinuria (ACR>30 or PCR>50)

  9. National Disease Prevalence Survey (%)

  10. CKD: A Typical GP Practice of 10000 5 6 15 4 60 Stage of Kidney Disease 30 (GFR) 380 3 60 2 460 90 1

  11. Incident Rates by Primary Diagnosis (per million population, unadjusted) USRDS, 2000

  12. Obesity Trends: UK

  13. Life expectancy: UK

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