International Society of Nephrology Global Kidney Health Atlas: structures, organization and services for the management of kidney failure in North and East Asia

Luxia Zhang^{1

2

3

4

5

6

7}, Jinwei Wang^{1

2

3

4

7}, Chih-Wei Yang⁸, Sydney Chi-Wai Tang⁹, Naoki Kashihara¹⁰, Yong-Soo Kim¹¹, Ariunaa Togtokh¹², Syed Saad¹³, Feng Ye¹³, Maryam Khan¹⁴, Deenaz Zaidi¹³, Mohamed A Osman¹⁵, Meaghan Lunney¹⁶, Ikechi G Okpechi^{13

17

18}, Vivekanand Jha^{19

20

21}, David C H Harris²², Adeera Levin²³, Marcello Tonelli^{24

25}, David W Johnson^{26

27

28}, Aminu K Bello²⁹, Ming-Hui Zhao^{1

2

4

30

31}; ISN North and East Asia Regional Board

Affiliations

¹ Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.
² Peking University Institute of Nephrology, Peking University, Beijing, China.
³ Key Laboratory of Renal Disease, National Health and Family Planning Commission of China, Beijing, China.
⁴ Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China.
⁵ Center for Data Science in Health and Medicine, Peking University, Beijing, China.
⁶ National Institute of Health Data Science at Peking University, Beijing, China.
⁷ Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.
⁸ Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
⁹ Division of Nephrology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
¹⁰ Department of Nephrology and Hypertension, Kawasaki Medical School, Okayama, Japan.
¹¹ Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
¹² Division of Nephrology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
¹³ Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
¹⁴ Faculty of Science, University of Alberta, Edmonton, Alberta, Canada.
¹⁵ Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁶ Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹⁷ Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
¹⁸ Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa.
¹⁹ George Institute for Global Health, University of New South Wales, New Delhi, India.
²⁰ School of Public Health, Imperial College, London, UK.
²¹ Manipal Academy of Higher Education, Manipal, India.
²² Centre for Transplantation and Renal Research, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia.
²³ Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
²⁴ Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
²⁵ Pan-American Health Organization/World Health Organization's Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada.
²⁶ Department of Nephrology, Metro South and Ipswich Nephrology and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
²⁷ Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia.
²⁸ Translation Research Institute, Brisbane, Queensland, Australia.
²⁹ Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Canada.
³⁰ Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
³¹ Peking-Tsinghua Center for Life Sciences, Beijing, China.

PMID: 33981473
PMCID: PMC8084719
DOI: 10.1016/j.kisu.2021.01.011

Review

International Society of Nephrology Global Kidney Health Atlas: structures, organization and services for the management of kidney failure in North and East Asia

Luxia Zhang et al. Kidney Int Suppl (2011). 2021 May.

. 2021 May;11(2):e77-e85.

doi: 10.1016/j.kisu.2021.01.011. Epub 2021 Apr 12.

Authors

Affiliations

¹ Renal Division, Department of Medicine, Peking University First Hospital, Beijing, China.
² Peking University Institute of Nephrology, Peking University, Beijing, China.
³ Key Laboratory of Renal Disease, National Health and Family Planning Commission of China, Beijing, China.
⁴ Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education of China, Beijing, China.
⁵ Center for Data Science in Health and Medicine, Peking University, Beijing, China.
⁶ National Institute of Health Data Science at Peking University, Beijing, China.
⁷ Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing, China.
⁸ Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
⁹ Division of Nephrology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
¹⁰ Department of Nephrology and Hypertension, Kawasaki Medical School, Okayama, Japan.
¹¹ Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
¹² Division of Nephrology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
¹³ Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
¹⁴ Faculty of Science, University of Alberta, Edmonton, Alberta, Canada.
¹⁵ Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
¹⁶ Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹⁷ Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.
¹⁸ Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa.
¹⁹ George Institute for Global Health, University of New South Wales, New Delhi, India.
²⁰ School of Public Health, Imperial College, London, UK.
²¹ Manipal Academy of Higher Education, Manipal, India.
²² Centre for Transplantation and Renal Research, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia.
²³ Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
²⁴ Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
²⁵ Pan-American Health Organization/World Health Organization's Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada.
²⁶ Department of Nephrology, Metro South and Ipswich Nephrology and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
²⁷ Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia.
²⁸ Translation Research Institute, Brisbane, Queensland, Australia.
²⁹ Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Canada.
³⁰ Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
³¹ Peking-Tsinghua Center for Life Sciences, Beijing, China.

PMID: 33981473
PMCID: PMC8084719
DOI: 10.1016/j.kisu.2021.01.011

Abstract

Kidney failure (KF) is a public health problem in all regions of the world. We aim to provide comprehensive information regarding the disease burden of KF and capacity for providing optimal care in the International Society of Nephrology North and East Asia region based on data from the International Society of Nephrology Global Kidney Health Atlas project. Seven of eight jurisdictions participated, and wide variation was found in terms of KF burden and care capacity. Prevalence of long-term dialysis ranged from 88.4 per million population in mainland China to 3251 per million population in Taiwan. Hemodialysis was the predominant modality of dialysis in all jurisdictions, except for Hong Kong, where peritoneal dialysis (PD) was much more prevalent than hemodialysis. All jurisdictions provided public funding for kidney replacement therapy (dialysis and transplantation). Although the frequency and duration of hemodialysis followed a standard pattern in all investigated jurisdictions, the density of nephrologists and kidney replacement therapy centers varied according to income level. Conservative care, whether medically advised or chosen by patients, was available in most jurisdictions. All jurisdictions had official registries for KF and recognized KF as a health priority. These comprehensive data provide information about the burden of KF and capacity to provide optimal care in North and East Asia, which varied greatly across jurisdictions in the region.

Keywords: Global Kidney Health Atlas; North and East Asia; end-stage kidney disease; epidemiology; kidney failure; kidney replacement therapy.

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Figures

**Figure 1**
**Countries in North and East Asia participating in the International Society of Nephrology Global Kidney Health Atlas survey**. NIS, Newly Independent States.

**Figure 2**
**Funding for kidney replacement therapy, nondialysis chronic kidney disease (CKD), and medications for dialysis and transplantation patients.** Values represent absolute number of countries in each category, expressed as a percentage of total number of countries. HD, hemodialysis; KRT, kidney replacement therapy; N/A, not provided; NGOs, nongovernmental organizations; PD, peritoneal dialysis.

**Figure 3**
**Providers primarily responsible for kidney failure care**.

**Figure 4**
**Availability of choice in kidney replacement therapy or conservative care for patients with kidney failure.** Values represent absolute number of countries in each category, expressed as a percentage of total number of countries. HD, hemodialysis; Kt/V, measure of dialysis adequacy; N/A, not provided; PD, peritoneal dialysis; URR, urea reduction ratio.

**Figure 5**
**Country scorecard for kidney care in the International Society of Nephrology North and East Asia region for registries, strategies, policies, and health priority designations.** AKI, acute kidney injury; CKD, chronic kidney disease; KF, kidney failure; NCD, noncommunicable disease.

See this image and copyright information in PMC

References

1. Wang J., Zhang L., Tang S.C. Disease burden and challenges of chronic kidney disease in North and East Asia. Kidney Int. 2018;94:22–25. - PubMed
1. Masakane I., Nakai S., Ogata S. Annual dialysis data report 2014, JSDT Renal Data Registry (JRDR) Ren Replace Ther. 2017;3:18.
1. Jin D.C., Yun S.R., Lee S.W. Lessons from 30 years' data of Korean end-stage renal disease registry, 1985-2015. Kidney Res Clin Pract. 2015;34:132–139. - PMC - PubMed
1. Yang W.C., Hwang S.J. Incidence, prevalence and mortality trends of dialysis end-stage renal disease in Taiwan from 1990 to 2001: the impact of national health insurance. Nephrol Dial Transplant. 2008;23:3977–3982. - PubMed
1. Ho Y.W., Chau K.-F., Choy B.Y. Hong Kong renal registry report 2012. Hong Kong J Nephrol. 2013;1:28–43.

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International Society of Nephrology Global Kidney Health Atlas: structures, organization and services for the management of kidney failure in North and East Asia

Affiliations

International Society of Nephrology Global Kidney Health Atlas: structures, organization and services for the management of kidney failure in North and East Asia

Authors

Affiliations

Abstract

Figures

References

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LinkOut - more resources

Full Text Sources

Other Literature Sources