1. DEVELOPMENT OF STRATEGIES FOR PREVENTION OF CHRONIC KIDNEY DISEASE RELEVENT TO DIFFERENT REGIONS AND COUNTRIES ROBERT C ATKINS BELLAGIO, MARCH 2004

2. USA: 283,000 Latin Am: 82,000 Eur: 317,000 India: 20.000 China: 30,000 AUS/NZL: 11,000 Japan: 167,000 Schena, Kidney Int (Suppl 74), 2000 World-ESRD (1996) Prevalence Incidence 1,000,000 220,000 DIALYSIS PATIENTS WORLD-WIDE (1996)

3. Incidence of Diabetes in E.S.R.F Australia 1980 - 2000 Year of Entry Number of DiabeticsNumber of New Patients

4.  Diabetes and hypertension are the main causes for ESRD in the USA  The proportion of ESRD patients with diabetic nephropathy is higher in the USA than in Europe. However, diabetic nephropathy is the most rapidly growing cause of ESRD in European countries CAUSES OF ESRD IN THE USA 19901992199419961998 0 20 40 60 80 100 120 140 Diabetes Hypertension Glomerulonephritis Cystic kidney Incidence rates (x million population) USRDS, 2000

5. AUSDIAB RESULTS 7.2% with diabetes (3.6% known and 3.6% newly diagnosed) 16.1% with impaired glucose metabolism 60% overweight or obese 61.3% with high cholesterol (7.3% on treatment) 29% with high blood pressure (14% on treatment)

6. PREVALENCE OF RENAL ABNORMALITIES 1.Haematuria >10x10 6 /L4.6% 2.Proteinuria2.4% UP:UC>0.2 mg/mg 3.Renal Impairment11.2% calculated GFR <60 mls/min No abnormality82% At least one abnormality18% Multiple abnormalities 2%

7. PREVALENCE OF TYPE 2 DIABETES IN ASIA AND PACIFIC Age-standardised to Segi’s world population 35-64 years except: * ³40 **30-59 ‡ 30-69 #20-64 § 40-69

8. World 2000 2025 154 m 300 m 55 m 72 m Developed Count.Developing Count. 99 m 228 m 16.7 24.5 39.3 18.2 38.4 30.7 21.8 9.1 57.2 22.8 37.5 18.6 0.40.7 2000 2025 * In million subjects 47% 116% 25% 140% 150% 102% 64% THE GLOBAL BURDEN OF DIABETES (2000-2025)