1. CHRONIC KIDNEY DISEASE The Philippine Situation

2. National Nutrition and Health Survey
Philippine Renal Disease Registry
Mortality statistics
Survival data from a cohort study

3. NATIONAL NUTRITION SURVEY
Resulted from the mandate of the Food and Research Institute (FNRI) of the Dept. of Science and Technology (DOST)
Objective: To assess the Philippine food situation and nutritional status of the population
Conducted every 5 years since 1978

4. NNHeS Objectives
To assess the prevalence of lifestyle and nutrition-related risk factors and diseases among Filipinos 2 years and above
To aid in the development of health policies an programs for the prevention and control of lifestyle and nutrition-related diseases

5. NNHeS 2003-2004 Renal Report Chronic Kidney Disease Stages
Stage GFR
1 >=90 Normal or increased GFR
Mildly decreased GFR
Moderately decreased GFR
Severely decreased GFR
5 <15 Kidney failure
Based on guidelines of the Dialysis Outcomes Quality Initiative – US

6. NNHeS 2003-2004 Renal Report Renal function
Abbreviated MDRD formula
Predicted GFR = * (serum creatinine)− * age− * (0.742 for women) * (1.21 if African American)
Cockcroft & Gault formula
Ccr (mL/min) = (140 − age)/sCr * weight/72 * 1.73/BSA, where age is in years, sCr is in mg/dL, weight is in kilograms, and BSA is body surface area using the formula:
BSA = × [height (m)]0.725 × [weight (kg)]0.425

7. The prevalence of CKD Stage 3-5 is 2.6%
NNHeS Renal Report Prevalence of CKD in adults using predicted GFR from MDRD equation
Stages of GFR
1 >= % % % %
5 < %
The prevalence of CKD Stage 3-5 is 2.6%

8. NNHeS 2003-2004 Renal Report Prevalence of CKD in adults
The population of Filipinos aged 20 years and above in 2005 was 46,627,172
A prevalence of 2.6% means that
1,212,306 adult Filipinos
have CKD.

9. NNHeS 2003-2004 Renal Report Macroalbuminuria
at least +1 proteinuria using the Multiple Reagent Strip for Urinalysis® (Bayer Corporation)
The prevalence of
macroalbuminuria was
4.2%

10. NNHeS 2003-2004 Renal Report Microalbuminuria
The prevalence of
microalbuminuria was
18.5%
This is equivalent to
8,626,027
Adult Filipinos

11. NNHeS 2003-2004 Renal Report Prevalence of CKD Stage 3-5 according to AGE
20.7%
7.5%
5.0%
2.9%
0.3%
1.0%

12. Mean level of GFR by age group: Philippine vs. US data
in Years
NNHeS 2003
Philippines
NHANES III
U.S.A.
20-29
119
116
30-39
109
107
40-49
103 99
50-59
100 93
60-69 86 85
70+ 77 75

13. PHILIPPINE RENAL DISEASE REGISTRY
Originated by the PSN in 1996 and later became a joint project with REDCOP
Collects data on ESRD patients who start hemodialysis, peritoneal dialysis and undergo kidney transplantation

14. NEW PATIENTS ON DIALYSIS 2001-2005
Number of Patients
2005: TOTAL INCREASE BY 7%
HD = 87%; INCREASE BY 8%
PD = 13%; INCREASE BY 1%
2004: TOTAL INCREASE BY 10%
HD = 87%; INCREASE BY 15%
PD = 13%; DECREASE BY 14%

15. NEW PATIENTS ON DIALYSIS: 2001-2005 ACCORDING TO DIALYSIS MODALITY
Number of Patients
2005: TOTAL INCREASE BY 7%
HD = 87%; INCREASE BY 8%
PD = 13%; INCREASE BY 1%
2004: TOTAL INCREASE BY 10%
HD = 87%; INCREASE BY 15%
PD = 13%; DECREASE BY 14%

16. ACCEPTANCE RATE TO RRT PROGRAMS (PMP) Data from International Federation of Renal Registries website and the Philippine Renal Disease Registry
71 PMP
55 PMP
63 PMP
68 PMP
Patients per million population

17. ACCEPTANCE RATE TO RRT PROGRAMS (PMP) Data from International Federation of Renal Registries website and the Philippine Renal Disease Registry
71 PMP
55 PMP
63 PMP
68 PMP
Patients per million population

18. PRIMARY RENAL DISEASE OF ALL NEW DIALYSIS PATIENTS
20%
26%
38%

19. DISTRIBUTION OF TOP 3 CAUSES OF ESRD
Number of Patients

20. NNHeS 2003-2004 Renal Report Prevalence of CKD Stage 3-5 according to AGE
MEAN AGE – 2004 PRDR DATA
ALL NEW DIALYSIS PTS YEARS
ESRD - DM NEPHRO YEARS
ESRD – HTN NEPHRO YEARS
ESRD – CGN YEARS
20.7%
7.5%
5.0%
2.9%
0.3%
1.0%

21. END STAGE RENAL IS A BAD DISEASE TO HAVE
Limited survival Expensive

22. Retrospective cohort study of 327 patients from NKTI and SLMC diagnosed to have ESRD OVERALL SURVIVAL
12 month estimated survival rate % (95%CI: 47-58)
24 month estimated survival rate % (95%CI: 30-42

23. Results PATIENT GROUP
Service – n=198 (60%) Private – n=129 (40%)
Log rank test: chi2 = 29.62, p<.001

24. National Statistics Office
Kidney disease is now no. 10 cause of mortality in the Philippines

25. GROWING PROBLEM OF CHRONIC KIDNEY DISEASE
NNHes Population Survey
Renal Disease Registry
ESRD survival data
National mortality data
GROWING PROBLEM OF CHRONIC KIDNEY DISEASE

26. Treatment is too expensive
Prevention is the key

27. Kung hindi tayo ang kikilos Sino ang kikilos?
Kung hindi ngayon, kailan pa?

28. Philippine Society of Nephrology
The Philippine College of Physicians wishes to acknowledge the following for their invaluable contribution in the preparation of this module
Philippine Society of Nephrology