China Kidney Disease Network (CK-NET) 2016 Annual Data Report

doi:10.1016/j.kisu.2020.09.001

. 2020 Dec;10(2):e97-e185.

doi: 10.1016/j.kisu.2020.09.001. Epub 2020 Dec 1.

China Kidney Disease Network (CK-NET) 2016 Annual Data Report

Luxia Zhang^{1

2

3}, Ming-Hui Zhao^{1

4

5}, Li Zuo⁶, Yue Wang⁷, Feng Yu^{1

4

8}, Hong Zhang^{1

4}, Haibo Wang²; CK-NET Work Group

Affiliations

¹ Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.
² National Institute of Health Data Science at Peking University, Beijing, China.
³ Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China.
⁴ Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.
⁵ Peking-Tsinghua Center for Life Sciences, Beijing, China.
⁶ Department of Nephrology, Peking University People's Hospital, Beijing, China.
⁷ Department of Nephrology, Peking University Third Hospital, Beijing, China.
⁸ Department of Nephrology, Peking University International Hospital, Beijing, China.

PMID: 33304640
PMCID: PMC7716083
DOI: 10.1016/j.kisu.2020.09.001

China Kidney Disease Network (CK-NET) 2016 Annual Data Report

Luxia Zhang et al. Kidney Int Suppl (2011). 2020 Dec.

. 2020 Dec;10(2):e97-e185.

doi: 10.1016/j.kisu.2020.09.001. Epub 2020 Dec 1.

Authors

Luxia Zhang^{1

2

3}, Ming-Hui Zhao^{1

4

5}, Li Zuo⁶, Yue Wang⁷, Feng Yu^{1

4

8}, Hong Zhang^{1

4}, Haibo Wang²; CK-NET Work Group

Affiliations

¹ Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.
² National Institute of Health Data Science at Peking University, Beijing, China.
³ Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China.
⁴ Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.
⁵ Peking-Tsinghua Center for Life Sciences, Beijing, China.
⁶ Department of Nephrology, Peking University People's Hospital, Beijing, China.
⁷ Department of Nephrology, Peking University Third Hospital, Beijing, China.
⁸ Department of Nephrology, Peking University International Hospital, Beijing, China.

PMID: 33304640
PMCID: PMC7716083
DOI: 10.1016/j.kisu.2020.09.001

No abstract available

PubMed Disclaimer

Figures

**Figure 1**
**Prevalence of CKD among different types of underlying disease.** CKD, chronic kidney disease; CVD, cardiovascular disease; DM, diabetes mellitus; HT, hypertension.

**Figure 2**
**Patients with CKD, stratified by sex and age.** CKD, chronic kidney disease.

**Figure 3**
**Patients with CKD, stratified by urban versus rural area (percent values).** CKD, chronic kidney disease.

**Figure 4**
**Age distribution of patients with CKD, stratified by sex**. CKD, chronic kidney disease.

**Figure 5**
**Sex distribution of patients with CKD, stratified by age.** Digits in columns represent percent values. CKD, chronic kidney disease.

**Figure 6**
**Cause distribution of patients with CKD.** Digits above columns represent percent values. CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 7**
**Cause of patients with CKD, stratified by urban versus rural area.** Digits above columns represent percent values. CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 8**
**Cause of patients with CKD, stratified by geographic region.** C, Central China; CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; E, East China; GN, glomerulonephritis; HTN, hypertensive nephropathy; N, North China; NE, Northeast China; NW, Northwest China; ON, obstructive nephropathy; Others, CKD due to other reasons; S, South China; SW, Southwest China.

**Figure 9**
**Staging of CKD, stratified by hospital nephrology unit.** CKD, chronic kidney disease.

**Figure 10**
**The travel pattern of patients with CKD.** Reference line represents the overall percentage of flow of CKD (5.98%). C, Central China; CKD, chronic kidney disease; E, East China; N, North China; NE, Northeast China; NW, Northwest China; S, South China; SW, Southwest China.

**Figure 11**
**Prevalence of CVD, stratified by patient group.** CHD, coronary heart disease; CKD, chronic kidney disease; CVD, cardiovascular disease; DM, diabetes mellitus.

**Figure 12**
**Prevalence of CHD, stratified by sex.** CHD, coronary heart disease; CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 13**
**Prevalence of CHD, stratified by age.** Point size refers to the percentage of CHD. CHD, coronary heart disease; CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 14**
**Prevalence of stroke, stratified by sex.** CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 15**
**Prevalence of stroke, stratified by age.** Point size refers to the percentage of stroke. CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 16**
**Prevalence of heart failure, stratified by sex.** CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 17**
**Prevalence of heart failure, stratified by age.** Point size refers to the percentage of heart failure. CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 18**
**Prevalence of atrial fibrillation, stratified by sex.** CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 19**
**Prevalence of atrial fibrillation, stratified by age.** Point size refers to the percentage of atrial fibrillation. CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 20**
**Prevalence of CVD among patients with CKD.** CHD, coronary heart disease; CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; CVD, cardiovascular disease; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 21**
**Prevalence of CHD among patients with CKD, stratified by nephropathy type and sex.** CHD, coronary heart disease; CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 22**
**Prevalence of CHD among patients with CKD, stratified by nephropathy type and age.** Point size refers to the percentage of CHD. CHD, coronary heart disease; CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 23**
**Prevalence of stroke among patients with CKD, stratified by nephropathy type and sex.** CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 24**
**Prevalence of stroke among patients with CKD, stratified by nephropathy type and age.** Point size refers to the percentage of stroke. CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 25**
**Prevalence of heart failure among patients with CKD, stratified by nephropathy type and sex.** CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 26**
**Prevalence of heart failure among patients with CKD, stratified by nephropathy type and age.** Point size refers to the percentage of heart failure. CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 27**
**Prevalence of atrial fibrillation among patients with CKD, stratified by nephropathy type and sex.** CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 28**
**Prevalence of atrial fibrillation among patients with CKD, stratified by nephropathy type and age.** Point size refers to the percentage of atrial fibrillation. CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 29**
**Cardiovascular procedures stratified by patient group.** CABG, coronary artery bypass grafting; CAG, coronarography; CKD, chronic kidney disease; DM, diabetes mellitus; PCI, percutaneous coronary intervention.

**Figure 30**
**Cardiovascular procedure: CAG, stratified by sex.** CAG, coronarography; CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 31**
**Cardiovascular procedure: CAG, stratified by age.** CAG, coronarography; CKD, chronic kidney disease; DM, diabetes mellitus. Point size refers to the percentage of CAG.

**Figure 32**
**Cardiovascular procedure: PCI, stratified by sex.** CKD, chronic kidney disease; DM, diabetes mellitus; PCI, percutaneous coronary intervention.

**Figure 33**
**Cardiovascular procedure: PCI, stratified by age.** CKD, chronic kidney disease; DM, diabetes mellitus; PCI, percutaneous coronary intervention. Point size refers to the percentage of PCI.

**Figure 34**
**Cardiovascular procedure: CABG, stratified by sex.** CABG, coronary artery bypass grafting; CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 35**
**Cardiovascular procedure: CABG, stratified by age.** CABG, coronary artery bypass grafting; CKD, chronic kidney disease; DM, diabetes mellitus. Point size refers to the percentage of CABG.

**Figure 36**
**Cardiovascular procedure: pacemaker, stratified by sex.** CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 37**
**Cardiovascular procedure: pacemaker, stratified by age.** Point size refers to the percentage of pacemaker. CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 38**
**Cardiovascular procedures among patients with CKD.** CABG, coronary artery bypass grafting; CAG, coronarography; CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons; PCI, percutaneous coronary intervention.

**Figure 39**
**Costs stratified by types of health insurance.** The box plot shows the distribution of hospitalization costs for different types of health insurance. Limited to 1.5 * third quartile. Red points refer to cost per person per year. CKD, chronic kidney disease; DM, diabetes mellitus; NRCMS, new rural co-operative medical care; UBMI, urban basic medical insurance.

**Figure 40**
**Costs stratified by sex.** The box plot shows the distribution of hospitalization costs by sex. Limited to 1.5 * third quartile. Red points refer to cost per person per year. CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 41**
**Costs stratified by age group (mean).** CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 42**
**Length of hospital stay stratified by types of health insurance.** Limited to 1.5 * third quartile. Red points refer to LOS per person per year. CKD, chronic kidney disease; DM, diabetes mellitus; LOS, length of hospital stay; NRCMS, new rural co-operative medical care; UBMI, urban basic medical insurance.

**Figure 43**
**Length of hospital stay stratified by sex.** Limited to 1.5 * third quartile. Red points refer to LOS per person per year. CKD, chronic kidney disease; DM, diabetes mellitus; LOS, length of hospital stay.

**Figure 44**
**Length of hospital stay stratified by age group (mean).** CKD, chronic kidney disease; DM, diabetes mellitus; LOS, length of hospital stay.

**Figure 45**
**In-hospital mortality stratified by different types of insurance.** CKD, chronic kidney disease; DM, diabetes mellitus; NRCMS, new rural co-operative medical care; UBMI, urban basic medical insurance.

**Figure 46**
**In-hospital mortality stratified by sex.** CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 47**
**In-hospital mortality stratified by age group.** Point size refers to mortality rate. CKD, chronic kidney disease; DM, diabetes mellitus.

**Figure 48**
**Percentage of AKI with and without ICU stay, stratified by geographic region.** AKI, acute kidney injury; C, Central of China; E, East of China; ICU, intensive care unit; N, North of China; NE, Northeast of China; NW, Northwest of China; S, South of China; SW, Southwest of China.

**Figure 49**
**Percentage of AKI among patients with CKD.** AKI, acute kidney injury; CKD, chronic kidney disease; CTIN, chronic tubulointerstitial nephropathy; DKD, diabetic kidney disease; GN, glomerulonephritis; HTN, hypertensive nephropathy; ON, obstructive nephropathy; Others, CKD due to other reasons.

**Figure 50**
**Age distribution of AKI patients, stratified by sex.** AKI, acute kidney injury.

**Figure 51**
**Sex distribution of AKI patients, stratified by age.** AKI, acute kidney injury.

**Figure 52**
**Percentage of CKD among patients with AKI, stratified by sex and age.** AKI, acute kidney injury; CKD, chronic kidney disease.

**Figure 53**
**Percentage of diabetes mellitus among patients with AKI, stratified by sex and age.** AKI, acute kidney injury.

**Figure 54**
**Distribution of HD and PD patients among different hospital levels.** HD, hemodialysis; PD, peritoneal dialysis.

**Figure 55**
**Incidence of dialysis patients, stratified by age and sex.** PMP, per million population.

**Figure 56**
**Percentage of dialysis patients who underwent 1 or more measurements of (a) hemoglobin and (b) serum ferritin in 2016.** HD, hemodialysis; PD, peritoneal dialysis.

**Figure 57**
**Percentage of dialysis patients who underwent 1 or more measurements of (a) serum calcium, (b) serum phosphorus, and (c) serum parathyroid hormone in 2016.** HD, hemodialysis; PD, peritoneal dialysis; PTH, parathyroid hormone.

**Figure 58**
**Percentage of dialysis patients receiving anemia-related treatment.** EPO, erythropoietin; HD, hemodialysis; PD, peritoneal dialysis.

**Figure 59**
**Percentage of dialysis patients receiving MBD-related treatment.** HD, hemodialysis; MBD, mineral and bone disorder; PD, peritoneal dialysis.

**Figure 60**
**Percentage of dialysis patients who underwent blood albumin testing.** HD, hemodialysis; PD, peritoneal dialysis.

**Figure 61**
**Diabetes-related examinations among dialysis patients with diabetes.** HD, hemodialysis; PD, peritoneal dialysis.

**Figure 62**
**Percentages of different types of CVD among dialysis patients, by modality.** AF, atrial fibrillation; AMI, acute myocardial infarction; CHD, coronary heart disease; CVA/TIA, cerebrovascular accident/transient ischemic attack; CVD, cardiovascular disease; HD, hemodialysis; HF, heart failure; PAD, peripheral arterial disease; PD, peritoneal dialysis.

**Figure 63**
**Percentages of dialysis patients receiving cardiovascular procedures, by modality.** HD, hemodialysis; PCI, percutaneous coronary intervention; PD, peritoneal dialysis.

**Figure 64**
**Geographical location of Shandong, Zhejiang, and Xinjiang provinces in China.** Shandong and Zhejiang are in the east of China, and Xinjiang is in the northwest of China.

**Figure 65**
**Hepatitis B/C virus infection in (a) HD and (b) PD patients in Shandong, Zhejiang, and Xinjiang in China (%).** Data on PD in Shandong Province were not provided. HD, hemodialysis; PD, peritoneal dialysis.

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References

1. GBD Chronic Kidney Disease Collaboration Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet (London, England) 2020;395:709–733. - PMC - PubMed
1. Foreman K.J., Marquez N., Dolgert A. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. Lancet (London, England) 2018;392:2052–2090. - PMC - PubMed
1. Zhang L., Wang F., Wang L. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet (London, England) 2012;379:815–822. - PubMed
1. Liu Z.H. Nephrology in china. Nat Rev Nephrol. 2013;9:523–528. - PubMed
1. Yang C., Kong G., Wang L. Big data in nephrology: Are we ready for the change? Nephrology (Carlton) 2019;24:1097–1102. - PubMed

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[1] GBD Chronic Kidney Disease Collaboration Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet (London, England) 2020;395:709–733. - PMC - PubMed

[2] GBD Chronic Kidney Disease Collaboration Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet (London, England) 2020;395:709–733. - PMC - PubMed

[3] Foreman K.J., Marquez N., Dolgert A. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. Lancet (London, England) 2018;392:2052–2090. - PMC - PubMed

[4] Foreman K.J., Marquez N., Dolgert A. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. Lancet (London, England) 2018;392:2052–2090. - PMC - PubMed

[5] Zhang L., Wang F., Wang L. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet (London, England) 2012;379:815–822. - PubMed

[6] Zhang L., Wang F., Wang L. Prevalence of chronic kidney disease in China: a cross-sectional survey. Lancet (London, England) 2012;379:815–822. - PubMed

[7] Liu Z.H. Nephrology in china. Nat Rev Nephrol. 2013;9:523–528. - PubMed

[8] Liu Z.H. Nephrology in china. Nat Rev Nephrol. 2013;9:523–528. - PubMed

[9] Yang C., Kong G., Wang L. Big data in nephrology: Are we ready for the change? Nephrology (Carlton) 2019;24:1097–1102. - PubMed

[10] Yang C., Kong G., Wang L. Big data in nephrology: Are we ready for the change? Nephrology (Carlton) 2019;24:1097–1102. - PubMed

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China Kidney Disease Network (CK-NET) 2016 Annual Data Report

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China Kidney Disease Network (CK-NET) 2016 Annual Data Report

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