Chronic Kidney Disease
Incidence and Prevalence of Stage 5 CKD
The incidence of stage 5 CKD varies between world regions and from country to country, and in many countries the incidence is predicted to increase.2,3,7,8 Although it affects <1% of the overall population, the prevalence of stage 5 CKD is increasing at an annual average rate of 7%,1,6 and it is estimated that by 2010 the number of persons receiving treatment for stage 5 CKD will reach approximately 2 million (Figure 1).1,2 As for all stages of CKD, the primary factors driving the increasing prevalence of stage 5 disease are the worldwide expansion of the ageing, multi-morbid population and the growing number of patients with hypertension and type 2 diabetes mellitus.4-6 Lesser contributing factors include the longer life expectancy of treated patients with stage 5 CKD and expanding access to treatment in countries where access has previously been limited.5
Figure 1. Increasing prevalence of CKD patients requiring dialysis worldwide
Adapted from Lysaght 2002.1
In 2004, patients aged 75 years or older in the US accounted for >25% of patients beginning therapy for stage 5 CKD; in 1980, that age group accounted for only 7.6% of new patients. The overall median age of new patients in 2004 was 65 years. Gender is also an important risk factor for stage 5 CKD5 and gender differences were observed to widen from 2003 to 2004: the number of new male patients grew by 3%, and the number of new female patients fell by 1%.
1. Lysaght MJ. Maintenance dialysis population dynamics: current trends and long-term implications. J Am Soc Nephrol. 2002;13(Suppl 1):S37-S40.
2. U.S. Renal Data System, USRDS 2006 Annual Data Report: Atlas of End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2006.
3. Grassmann A, Gioberge S, Moeller S, Brown G. ESRD patients in 2004: global overview of patient numbers, treatment modalities and associated trends. Nephrol Dial Transplant. 2005;20:2587-2593.
4. Bommer J. Prevalence and socio-economic aspects of chronic kidney disease. Nephrol Dial Transplant. 2002;17(Suppl 11):8-12.
5. Moeller S, Gioberge S, Brown G. ESRD patients in 2001: global overview of patients, treatment modalities and development trends. Nephrol Dial Transplant. 2002;17:2071-2076.
6. White SL, Cass A, Atkins RC, Chadban SJ. Chronic kidney disease in the general population. Adv Chronic Kidney Dis. 2005;12:5-13.
7. Lameire N, Jager K, Van Biesen W, de Bacquer D, Vanholder R. Chronic kidney disease: a European perspective. Kidney Int Suppl. 2005;(99):S30-S38.
8. El Nahas AM, Bello AK. Chronic kidney disease: the global challenge. Lancet. 2005;365:331-340.