TY - JOUR
T1 - CKD in China
T2 - Evolving Spectrum and Public Health Implications
AU - Yang, Chao
AU - Wang, Haibo
AU - Zhao, Xinju
AU - Matsushita, Kunihiro
AU - Coresh, Josef
AU - Zhang, Luxia
AU - Zhao, Ming Hui
N1 - Funding Information:
Chao Yang, MS, Haibo Wang, MBBS, MSc, MPH, Xinju Zhao, MD, Kunihiro Matsushita, MD, PhD, Josef Coresh, MD, PhD, Luxia Zhang, MD, MPH, and Ming-Hui Zhao, MD. This study was funded by the National Key Technology R&D Program of the Ministry of Science and Technology of the People's Republic of China (2016YFC1305400), and the University of Michigan Health System-Peking University Health Science Center Joint Institute for Translational and Clinical Research (BMU20160466). The funders had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication. The authors declare that they have no relevant financial interests. The authors thank the Bureau of Medical Administration and Medical Service Supervision, NHC of the People's Republic of China, the Ministry of Science and Technology of the People's Republic of China, the University of Michigan Health System-Peking University Health Science Center Joint Institute, and the WHO for the support of this study. Received November 14, 2018. Evaluated by 2 external peer reviewers, with direct editorial input from an Associate Editor and a Deputy Editor. Accepted in revised form May 29, 2019.
Funding Information:
The authors thank the Bureau of Medical Administration and Medical Service Supervision, NHC of the People’s Republic of China, the Ministry of Science and Technology of the People’s Republic of China, the University of Michigan Health System- Peking University Health Science Center Joint Institute, and the WHO for the support of this study.
Funding Information:
This study was funded by the National Key Technology R&D Program of the Ministry of Science and Technology of the People’s Republic of China ( 2016YFC1305400 ), and the University of Michigan Health System- Peking University Health Science Center Joint Institute for Translational and Clinical Research ( BMU20160466 ). The funders had no role in study design; collection, analysis, or interpretation of data; writing the report; or the decision to submit the report for publication.
Publisher Copyright:
© 2019 National Kidney Foundation, Inc.
PY - 2020/8
Y1 - 2020/8
N2 - Diabetes is the leading cause of kidney failure worldwide, whereas glomerulonephritis has been predominant in developing countries such as China. The prevalence of obesity and diabetes has increased dramatically in developing countries, substantially affecting the patterns of chronic kidney disease (CKD) observed in these regions. Using data from the Hospital Quality Monitoring System to evaluate changes in the spectrum of non–dialysis-dependent CKD in China, we have observed an increase in the percentage of patients with CKD due to diabetes, which has exceeded that of CKD due to glomerulonephritis since 2011, as well as an increase in hypertensive nephropathy and, in some regions, obstructive kidney disease (mostly associated with kidney stones). The growth of noncommunicable diseases under profound societal and environmental changes has shifted the spectrum of CKD in China toward patterns similar to those of developed countries, which will have enormous impacts on the Chinese health care system. There is much to be done regarding public health interventions, including the establishment of a national CKD surveillance system, improvement in the management of diabetes and hypertension, and enhancement of the affordability and accessibility of kidney replacement therapy. Reducing the burden of CKD will require joint efforts from government, the medical community (including practitioners other than nephrologists), and the public.
AB - Diabetes is the leading cause of kidney failure worldwide, whereas glomerulonephritis has been predominant in developing countries such as China. The prevalence of obesity and diabetes has increased dramatically in developing countries, substantially affecting the patterns of chronic kidney disease (CKD) observed in these regions. Using data from the Hospital Quality Monitoring System to evaluate changes in the spectrum of non–dialysis-dependent CKD in China, we have observed an increase in the percentage of patients with CKD due to diabetes, which has exceeded that of CKD due to glomerulonephritis since 2011, as well as an increase in hypertensive nephropathy and, in some regions, obstructive kidney disease (mostly associated with kidney stones). The growth of noncommunicable diseases under profound societal and environmental changes has shifted the spectrum of CKD in China toward patterns similar to those of developed countries, which will have enormous impacts on the Chinese health care system. There is much to be done regarding public health interventions, including the establishment of a national CKD surveillance system, improvement in the management of diabetes and hypertension, and enhancement of the affordability and accessibility of kidney replacement therapy. Reducing the burden of CKD will require joint efforts from government, the medical community (including practitioners other than nephrologists), and the public.
KW - CKD prevalence
KW - China
KW - Chronic kidney disease (CKD)
KW - chronic disease surveillance
KW - developing world
KW - diabetes
KW - disease burden
KW - end-stage kidney disease (ESKD)
KW - health care costs
KW - hypertension
KW - kidney disease etiology
KW - lifestyle factors
KW - metabolic diseases
KW - modifiable risk factor
KW - non-communicable diseases
KW - obesity
KW - public health
KW - review
KW - urbanization
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U2 - 10.1053/j.ajkd.2019.05.032
DO - 10.1053/j.ajkd.2019.05.032
M3 - Article
C2 - 31492486
AN - SCOPUS:85071652801
SN - 0272-6386
VL - 76
SP - 258
EP - 264
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 2
ER -