Section 1: CKD Epidemiology. The Problem Chronic Kidney Disease is an epidemic worldwide –Growth 6-8% per annum of dialysis patients Accumulating data.

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Presentation transcript:

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. Under-recognition at earlier stages of kidney dysfunction persists –Late referral –Lost opportunities for improved patient outcomes

RRT Modalities 36,542 DOD/

Patients Accepted in the UK for Renal Replacement Therapy

Cadaveric Kidney Donors & Transplants and End of Year Kidney Waiting List, UK, DOD/

Prevalence of renal replacement therapy Take-on rates /pmp England98 Wales118 France200 Italy260 USA315

Estimates of Prevalence of CKD in the US: NHANES III StageDescription GFR (ml/min/1.73 m 2 ) Prevalence (000s) Prevalence (%) 1 Kidney Damage with Normal or  GFR >905, Kidney Damage with Mild  GFR , Moderate  GFR , Severe  GFR Kidney Failure <15 or (or dialysis) Adapted from Am J Kidney Dis 2002; 39 (2, Suppl. 1): S17-S31

NICE: 2008 Classification of CKD waking up to the impact of proteinuria Stage 1:GFR>90 + abnormal urinalysis Stage 2:GFR abnormal urinalysis Stage 3A:GFR Stage 3B:GFR Stage 4:GFR Stage 5: GFR <15 or dialysis dependent Suffix P denotes presence of proteinuria (ACR>30 or PCR>50)

National Disease Prevalence Survey (%)

CKD: A Typical GP Practice of (GFR) Stage of Kidney Disease

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

Obesity Trends: UK

Life expectancy: UK