- Email: [email protected]
International Comparisons
Twelve International comparisons
Home, I said In every language there is a word for it. In the body itself, climbing those walls of white thunder, past those green temples, there is also a word for it. I said, home.
Mary Oliver, “The River”
Chapter
American Journal of Kidney Diseases, Vol 53, No 1, Suppl 1 (January, 2009), pp S297–S308.
We are pleased this year to present data from 44 regions and countries, again offering a worldwide picture of ESRD and the ways in which practitioners choose to treat it. This year we update our figures comparing the incidence and prevalence of ESRD around the world. As reported in 2005, Taiwan (whose data include only dialysis patients), the United States, and Jalisco (Mexico) again report the highest rates of incident ESRD at 418, 363, and 346 per million population, respectively. Iceland, Iran, Romania, the Philippines, and Finland, in contrast, report rates of 59–84, while reported rates are lowest in Bangladesh, Russia, and Pakistan, at 9, 28, and 29 per million population, respectively. Diabetes as a primary cause of ESRD accounts for a large proportion of incident ESRD patients. Malaysia, for example, reports a 2006 incident rate of 119 per million population— and nearly 58 percent of these patients have diabetes. Jalisco, the United States, Japan, Taiwan, the Republic of Korea, New Zealand, Hong Kong, and Israel all report rates of diabetes exceeding 40 percent. Prevalent rates for 2006 were highest in Taiwan and Japan (dialysis only), at 2,226 and 1,956 per million population, respectively, followed by the United States and Germany at 1,641, and 1,114. And reported rates for Jalisco have more than doubled in a span of four years, increasing from 394 in 2003 to 929 per million in 2006. Hemodialysis is the most common mode of dialysis therapy world-wide, evidenced by data showing that, in
over 60 percent of reporting countries, at least 80 percent of patients are on this mode of therapy. This is not the case, however, in countries such as Hong Kong and Jalisco, where peritoneal dialysis is provided to 81 and 71 percent of patients, respectively. And home hemodialysis therapy is provided to nearly 10 percent of patients in Australia and to 16 percent of patients in New Zealand. Renal transplant rates are many times a reflection not only of a country’s health-care system, but of cultural diversities as well. Transplant rates, for example, are less than 10 per million population in countries such as Hong Kong, the Philippines, Romania, and Malaysia, in contrast to rates exceeding 60 per million in Spain and the United States. Rates of functioning grafts reach 506 and 537 per million, respectively, in the United States and Norway, but are less than 30 per million in Russia, Thailand, Romania, and Bangladesh. We invite all renal registries to send their data, using the form provided on page 243. You may return it to us by email or fax: [email protected], and 1.612.347.5878. We wish to thank all participating registries for their willingness to provide data on their ESRD programs and help us give a perspective on patients with ESRD worldwide.
II
12.1
Comparison of ESRD incidence & prevalence worldwide
450
Incidence
2,400
Taiwan
Prevalence Taiwan
2,200 400 2,000
United States
Japan 1,800
300
250 Japan
Germany Israel
200
Rep. of Korea
150
Prevalent rate per million population
Incident rate per million population
350
United States 1,600
1,400
Australia Norway Rep. of Korea Sweden
1,200
1,000
Germany
uay Urug 800
Uruguay 600
Sweden
Malaysia
Israel
100 Norway
400
Australia
Malaysia 50
Jalisco (Mexico) 200
1999
2000
2001
2002
2003
2004
2005
2006
1999
2000
2001
2002
2003
2004
2005
2006
figure 12.1 all rates are unadjusted. Data from Israel, Japan, & Taiwan are dialysis only. Incident data for Jalisco not shown due to high year-to-year variability.
highlights figure 12.3 & table 12.b Diabetes was the primary cause of ESRD in 58 percent of new patients in Malaysia in 2006, and 50 percent of those in Jalisco (Mexico). In a majority of reporting countries, 20–44 percent of new patients have this primary diagnosis. figure 12.6 & table 12.e Reported prevalent rates of functioning grafts are greatest in Norway and the United States, at 537 and 506 per million population in 2006, respectively.
contents incidence of ESRD · S300 overall incident rates ESRD due to diabetes prevalence of ESRD · S302 overall prevalent rates dialysis · S303 patient distribution, by modality transplantation · S304 rates of functioning grafts transplant rates worldwide view of the incidence of ESRD · S306 international maps
Incidence of end-stage renal disease II
12.2
S300
Incidence of ESRD, 2006
Taiwan United States Jalisco (Mexico) Shanghai Japan Luxembourg Germany Israel Greece Turkey Belgium, Dutch sp. Belgium, French sp. Rep. of Korea Czech Republic Canada Hungary Austria Croatia Uruguay Argentina Chile Hong Kong France Thailand Bosnia/Herzegov. Spain Sweden Italy Malaysia New Zealand Australia Scotland Denmark Netherlands UK^ Norway Finland Philippines Romania Iran Iceland Pakistan Russia Bangladesh 0 150 300 450 Rate per million population
II
12.a
Incidence of ESRD, by year (per million population)
Australia Argentina Austria Bangladesh Belgium, Dutch speaking Belgium, French speaking Bosnia & Herzegovina Canada Chile Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary Iceland Iran Israel Italy Jalisco (Mexico) Japan Luxembourg Malaysia Netherlands New Zealand Norway Pakistan Philippines Rep. of Korea Romania Russia Scotland Shanghai Spain Sweden Taiwan Thailand Turkey U.K. (England, Wales, & N Ireland) United States Uruguay
2002
2003
2004
2005
2006
97 . 135 6 174 173
100 . 140 8 175 161 106 162 130 131 167 132 95 . 186 180 128 139 73 61 199 133 280 263 180 102 103 115 96 32 60 152 . 19 121 232 . 122 391 78 112 . 342 146
97 137 160 7 181 187 108 163 157 155 166 133 97 . 194 196 135 139 79 71 201 161 346 267 188 110 106 113 101 . 75 171 . 17 115 263 175 122 397 123 121 . 346 151
112 140 153 9 183 177 104 163 135 144 175 122 96 139 203 193 137 162 64 72 197 121 302 271 164 103 107 112 99 22 79 173 94 24 123 275 126 120 434 110 179 108 353 146
115 141 158 9 192 186 133 . 141 . 173 113 84 140 213 196 140 159 59 66 203 . 346 275 224 119 112 117 100 29 80 185 75 28 115 282 132 127 418 139 192 103 363 142
158 127 118 159 132 94 . 174 168 129 123 73 . 166 126 232 256 144 97 102 119 93 26 53 129 . 15 110 156 . 129 395 . 118 . 338 136
figure 12.2 & table 12.a Incident rates of reported ESRD are greatest in Taiwan (dialysis only), at 418 per million population in 2006, followed by the United States, Jalisco (Mexico), Shanghai, and Japan. Rates of 100 per million population or lower are reported by Bangladesh, Russia, Pakistan, Iceland, Iran, Romania, the Philippines, Finland, and Norway. It is important to note the distinction between the incidence of treatment, guided by available funding, and the incidence of a disease itself. An affluent nation may allow elderly patients and those with diabetes to receive hemodialysis, while developing nations may restrict this treatment to younger, healthier patients.
12.3
Percentage of incident patients with ESRD due to diabetes, 2006
II
12.b
2008 USRDS ANNUAL DATA REPORT
Percentage of incident patients with ESRD due to diabetes, by year
Malaysia Jalisco (Mexico)
Argentina Australia Austria Belgium, Dutch speaking Belgium, French speaking Bosnia & Herzegovina Canada Croatia Denmark Finland France Germany Greece Hong Kong Hungary Iceland Israel Italy Jalisco (Mexico) Japan Luxembourg Malaysia Netherlands New Zealand Norway Pakistan Philippines Rep. of Korea Romania Russia Scotland Spain Sweden Taiwan Turkey U.K. (England, Wales, & N Ireland) United States Uruguay
United States Japan Taiwan Rep. of Korea New Zealand Hong Kong Israel Philippines Pakistan Finland France Germany Argentina Iceland Austria Australia Greece Luxembourg Hungary Sweden Denmark Spain Turkey Belgium, French sp. Belgium, Dutch sp. Scotland Bosnia/Herzegov. UK^ Uruguay Norway Netherlands Russia Romania 0
15 30 45 60 Percent of patients
all figures & tables data presented only for those countries from which relevant information was available; “.” signifies data not reported. All rates are unadjusted. ^UK: England, Wales, & Northern Ireland (Scotland data reported separately). Data from Argentina, Czech Republic, Israel, Japan, Luxembourg, Shanghai, & Taiwan are dialysis only. Latest data for Canada, Croatia, & Italy are for 2005. Data for France include 13 regions in 2005 & 15 regions in 2006.
international comparisons
IIESRD
End-stage renal disease due to diabetes II
12
incidence of end-stage renal disease
2002
2003
2004
2005
2006
. 26.7 34.5 22.4 22.5 . 33.6 28.8 26.3 39.1 . 36.2 26.8 47.0 26.2 9.5 39.3 16.3 51.0 38.7 . 49.1 17.4 44.5 11.9 40.0 28.5 40.7 . 9.0 18.5 . 23.8 38.9 46.2 . 44.8 20.0
. 26.0 33.5 24.0 25.0 22.9 34.2 26.9 22.6 34.9 . 36.3 28.0 39.9 25.5 0.0 37.6 16.2 51.0 40.6 . 51.7 16.6 41.3 15.8 40.0 32.8 42.5 . 10.7 18.9 . 24.0 36.8 23.1 . 44.9 29.6
31.4 30.3 32.6 24.4 21.3 20.1 34.3 29.0 21.7 33.3 . 34.2 28.3 40.5 29.5 4.3 40.7 16.2 56.0 40.9 . 54.7 17.3 40.5 17.3 . 33.5 43.4 . . 17.8 17.5 24.9 38.0 21.3 . 45.0 21.8
34.7 31.4 33.6 24.0 23.7 20.6 34.9 30.0 24.1 34.6 23.3 34.9 29.4 42.0 26.2 15.8 38.7 18.0 60.0 41.6 . 52.0 15.6 41.8 12.9 36.3 36.9 38.5 10.7 11.0 21.9 23.2 25.8 40.7 30.2 19.0 44.4 29.6
33.8 32.4 32.9 22.2 22.5 21.5 . . 24.0 35.4 34.7 34.4 29.5 41.0 27.5 33.3 40.4 . 49.9 42.5 28.2 57.5 16.0 41.7 16.4 37.7 38.5 42.3 12.4 13.9 22.0 23.1 26.0 42.4 23.1 18.6 44.3 17.4
figure 12.3 & table 12.b Diabetes was the primary cause of ESRD in 58 percent of new patients in Malaysia in 2006, and 50 percent of those in Jalisco (Mexico). In a majority of reporting countries, 20–44 percent of new patients have this primary diagnosis. Countries with the lowest reported rates of ESRD due to diabetes include Romania, Russia, the Netherlands, Norway, Uruguay, and the United Kingdom (England, Wales, and Northern Ireland), each with 12–19 percent.
S301
Prevalence of end-stage renal disease II
12.4
S302
II
12.c
Prevalence of ESRD, 2006
Prevalence of ESRD, by year (per million population) Prevalent counts 2002 2003
Taiwan Japan United States Germany Belgium, French sp. Belgium, Dutch sp. Hong Kong Spain Greece France Rep. of Korea Chile Jalisco (Mexico) Uruguay Austria Sweden Denmark New Zealand Australia Scotland Netherlands Norway Finland Hungary UK^ Israel Malaysia Argentina Turkey Bosnia/Herzegov. Luxembourg Iceland Czech Republic Shanghai Romania Thailand Russia Bangladesh Philippines
Argentina Australia Austria Bangladesh Belgium, Dutch sp. Belgium, French sp. Bosnia & Herzegov. Canada Chile Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary Iceland Israel Italy Jalisco (Mexico) Japan Luxembourg Malaysia Netherlands New Zealand Norway Philippines Rep. of Korea Romania Russia Scotland Shanghai Spain Sweden Taiwan Thailand Turkey U.K. United States Uruguay 0
600
1,200 1,800 2,400
Rate per million population
. 13,017 6,303 8,265 5,260 3,850 . 28,222 11,314 3,100 7,092 3,851 3,305 . 75,777 9,266 5,670 6,060 125 3,796 48,977 2,432 220,196 199 10,531 10,594 2,715 2,917 1,853 33,993 . 11,517 3,457 . . 6,823 40,362 . 26,268 . 420,399 2,715
. 13,691 6,940 9,220 5,464 4,068 1,829 29,522 12,190 3,504 7,227 4,004 3,461 . 78,281 9,705 5,937 6,743 139 4,039 51,281 2,463 229,446 200 9,807 11,008 2,883 3,049 3,922 38,790 . 13,175 3,607 . . 6,972 42,945 15,004 28,549 . 437,652 2,675
2004
2005
21,034 14,259 7,345 10,274 5,733 4,342 1,867 31,025 13,450 3,582 7,743 4,157 3,598 . 82,305 10,199 6,274 6,310 140 4,267 59,185 3,170 236,606 209 13,348 11,455 2,996 3,255 4,375 41,891 . 14,720 3,693 . 39,578 7,211 45,710 15,083 31,251 . 455,181 2,895
22,333 15,136 7,244 11,565 6,022 4,523 2,009 32,493 14,160 3,708 4,638 4,245 3,748 31,557 87,151 10,637 6,571 5,901 143 4,439 44,387 5,455 240,513 224 14,628 11,980 3,110 3,386 7,288 44,333 5,504 16,483 3,844 . 28,366 7,394 48,685 13,741 33,014 37,962 473,472 2,807
Prevalent rates 2006 2002 2003 2004 2005 2006 23,306 . . 550 16,027 663 689 709 7,544 782 859 906 12,864 65 72 73 6,325 879 910 951 4,774 885 933 989 2,115 . 477 487 . 900 933 971 15,353 726 773 841 . 699 790 807 4,752 695 708 758 4,307 716 743 770 3,807 636 664 688 34,648 . . . 91,718 920 948 998 10,968 842 881 922 6,866 843 878 923 6,976 601 667 622 147 435 480 479 4,632 578 604 627 . 854 886 1,022 6,357 389 394 508 249,957 1,727 1,797 1,852 240 452 444 486 16,372 429 400 522 12,617 656 678 704 3,224 689 719 738 3,508 643 668 709 7,643 22 46 52 46,730 701 794 854 6,573 . . . 18,486 79 91 102 3,966 684 713 727 . 286 327 364 35,503 . . 1,098 7,677 764 778 802 50,920 1,792 1,900 2,015 17,967 . 235 243 42,992 374 419 433 36,577 . . . 493,624 1,452 1,498 1,543 3,073 807 846 893
figure 12.4 & table 12.c Taiwan (dialysis only) continues to report the greatest prevalent rates of ESRD, at 2,226 per million population in 2006. The next highest rates are reported by Japan and the United States, at 1,956 and 1,641. The lowest rates, of 88 and 92 per million population, are reported by the Philippines and Bangladesh.
579 745 891 83 994 1,024 524 1,007 866 836 452 783 714 932 1,057 958 961 590 482 641 755 808 1,882 498 560 734 759 732 87 900 254 115 754 404 868 819 2,138 220 451 689 1,589 849
598 778 912 92 1,037 1,073 552 . 930 . 462 792 723 957 1,114 984 994 699 484 657 . 929 1,956 522 615 772 779 753 88 942 304 130 775 447 991 845 2,226 286 589 659 1,641 927
12.5
Percent distribution of prevalent dialysis patients, by modality, 2006
Luxembourg Bangladesh Japan Argentina Thailand Bosnia/Herzegov. Chile Philippines Germany Uruguay Taiwan Czech Republic United States Israel Greece Russia Austria Croatia Malaysia Belgium, French sp. Belgium, Dutch sp. Turkey Spain Hungary Italy Romania France Norway Canada UK^ Rep. of Korea Scotland Finland Sweden Netherlands Denmark Iceland Australia New Zealand Jalisco (Mexico) Hong Kong
In-center HD Home HD CAPD/CCPD
0
20 40 60 80 100 Percent of patients
all figures & tables data presented only for those countries from which relevant information was available; “.” signifies data not reported. All rates are unadjusted. ^UK: England, Wales, & Northern Ireland (Scotland data reported separately). Data from Argentina, Czech Republic, Israel, Japan, Luxembourg, Shanghai, & Taiwan are dialysis only. Latest data for Canada, Croatia, & Italy are for 2005. Data for France include 13 regions in 2005 & 15 regions in 2006.
II
12.d
2008 USRDS ANNUAL DATA REPORT
international comparisons
IIESRD
Patient distribution, by type of dialysis II
12
prevalence of end-stage renal disease; dialysis
Percent distribution of prevalent dialysis patients, by modality & year Hemodialysis Home hemodialysis Peritoneal dialysis 2002 2003 2004 2005 2006 2002 2003 2004 2005 2006 2002 2003 2004 2005 2006
Argentina Australia Austria Bangladesh Belg/Dutch sp. Belgium/Fr. sp. Bosnia/Herz. Canada Chile Croatia Czech Rep. Denmark Finland France Germany Greece Hong Kong Hungary Iceland Israel Italy Jalisco (Mexico) Japan Rep. of Korea Luxembourg Malaysia Netherlands New Zealand Norway Philippines Romania Russia Scotland Spain Sweden Taiwan Thailand Turkey UK^ United States Uruguay
. 64.7 92.0 99.1 89.7 90.3 . 78.7 95.3 91.5 92.8 74.3 78.2 . 93.8 90.0 17.9 92.7 66.7 84.7 89.3 18.0 96.2 77.8 99.0 87.5 68.3 37.5 84.0 91.2 . 93.5 75.6 . 73.5 93.9 . 86.9 . 91.2 93.7
. 66.1 92.0 99.0 89.5 90.3 96.6 79.4 94.3 92.0 92.6 72.8 75.5 . 94.1 90.3 17.4 92.1 66.2 88.6 89.6 20.0 96.3 77.4 99.5 88.3 69.5 41.2 83.6 100 . 92.5 77.4 . 74.2 93.5 92.3 87.5 . 91.3 93.0
95.6 67.6 92.3 98.8 88.5 89.8 96.2 79.1 94.0 91.1 92.5 72.9 75.5 . 94.1 90.6 17.4 93.4 59.1 89.0 87.2 30.1 96.3 77.0 99.5 89.1 72.2 43.2 82.9 85.5 . 91.9 77.3 88.6 74.7 93.4 93.2 88.2 . 91.6 92.3
96.0 69.1 92.1 98.6 88.8 89.6 95.7 78.9 94.3 90.8 92.5 72.2 75.4 86.1 93.9 91.0 17.0 87.2 64.4 90.9 87.0 28.3 96.3 77.7 99.6 89.8 73.4 45.8 83.2 87.9 81.9 91.5 77.7 90.6 75.8 93.0 93.9 87.9 77.5 91.8 92.3
96.0 68.4 90.9 99.6 89.1 89.1 95.3 . 95.0 . 92.4 72.2 75.8 80.5 93.8 91.5 18.7 87.3 70.6 91.9 . 29.5 96.5 78.4 100 90.0 74.8 45.1 80.4 94.5 80.7 91.0 78.4 88.6 75.4 92.4 95.8 88.7 78.7 91.9 92.6
. 10.7 0.3 0.0 0.1 1.0 . 1.5 0.02 0.0 0.02 1.1 2.9 . 0.90 0.01 0.17 0.0 0.0 0.0 0.0 0.0 0.03 0.0 0.5 2.4 1.8 14.4 0.3 0.0 . 0.0 2.5 . 2.3 0.0 . 0.0 . 0.6 0.0
. 10.1 0.2 0.0 0.1 1.2 0.0 1.7 0.02 0.0 0.02 1.6 3.2 . 0.83 0.14 0.14 0.0 0.0 0.0 0.0 0.0 0.04 0.0 0.5 2.1 2.0 14.0 0.2 0.0 . 0.0 2.4 . 2.3 0.0 0.0 0.0 . 0.6 0.0
0.0 10.0 0.2 0.0 0.2 1.2 0.0 2.0 0.02 0.0 0.02 2.3 3.5 . 0.79 0.03 0.03 0.0 1.5 0.0 0.8 0.0 0.04 0.0 0.5 1.5 2.1 14.8 0.2 0.0 . 0.0 2.3 0.0 2.9 0.0 0.0 0.0 . 0.6 0.0
0.0 9.4 0.2 0.0 0.2 1.2 0.0 2.5 0.02 0.0 0.02 3.0 3.2 2.4 0.83 0.03 0.0 0.0 0.0 0.0 0.7 0.0 0.05 0.0 0.4 1.3 2.0 15.8 0.5 0.0 0.0 0.0 2.1 0.0 3.1 0.0 0.0 0.0 2.2 0.7 0.0
0.0 9.5 0.2 0.0 0.2 1.3 0.0 . 0.02 . 0.00 3.8 3.0 7.5 0.85 0.05 0.0 0.0 0.0 0.0 . 0.0 0.06 0.0 0.0 1.1 2.2 16.2 0.4 0.0 0.0 0.0 1.7 0.1 2.6 0.0 0.0 0.0 2.0 0.7 0.0
. 24.6 7.7 0.9 10.2 8.7 . 19.8 4.7 8.5 7.2 24.7 18.9 . 5.3 10.0 81.9 7.3 33.3 15.3 10.7 82.0 3.8 22.2 0.5 10.1 29.9 48.1 15.7 8.8 . 6.5 21.9 . 24.2 6.1 . 13.1 . 8.2 6.3
figure 12.5 & table 12.d In Hong Kong, 81 percent of patients were treated with CAPD/CCPD in 2006, the highest reported rate worldwide. The therapy is also widely used in Jalisco (Mexico), at 70 percent, and in New Zealand and Iceland, at 39 and 29 percent, respectively. Fewer than 5 percent of patients, in contrast, are treated with peritoneal dialysis in Luxembourg, Bangladesh, Japan, Argentina, Thailand, and Bosnia and Herzogovina. Reported use of home hemodialysis is greatest in New Zealand and Australia, at 16 and 9.5 percent.
. 23.8 7.8 1.0 10.4 8.5 3.4 18.9 5.7 8.0 7.4 25.7 21.3 . 5.1 9.7 82.5 7.9 33.8 11.4 10.4 80.0 3.7 22.6 0.0 9.6 28.5 44.8 16.1 0.0 . 7.5 20.2 . 23.5 6.5 7.7 12.5 . 8.1 7.0
4.4 22.4 7.5 1.2 11.3 9.0 3.8 18.9 6.0 8.9 7.5 24.8 21.0 . 5.1 9.4 82.6 6.6 39.4 11.0 12.0 69.9 3.6 23.0 0.0 9.4 25.7 41.9 16.9 14.5 . 8.1 20.4 11.4 22.4 6.6 6.8 11.8 . 7.8 7.7
4.0 21.5 7.7 1.4 11.1 9.2 4.3 18.7 5.6 9.2 7.5 24.8 21.4 11.5 5.2 9.0 83.0 12.8 35.6 9.1 12.3 71.7 3.6 22.3 0.0 8.8 24.5 38.4 16.2 12.1 18.1 8.5 20.2 9.4 21.1 7.0 6.1 12.1 20.3 7.6 7.7
4.0 22.0 9.0 0.4 10.7 9.6 4.7 . 5.0 . 7.6 24.0 21.3 12.0 5.3 8.5 81.3 12.7 29.4 8.1 . 70.5 3.4 21.6 0.0 8.9 23.0 38.8 19.2 5.5 19.3 9.0 19.8 11.3 22.0 7.6 4.2 11.3 19.3 7.4 7.4
S303
Prevalent rates of functioning grafts II
12.6
II
12.e
Prevalent rates of functioning grafts, 2006
Prevalent rates of functioning grafts, by year (per million population)
Norway
S304
United States
Australia Austria Bangladesh Belgium, Dutch speaking Belgium, French speaking Bosnia & Herzegovina Canada Chile Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary Iceland Italy Jalisco (Mexico) Rep. of Korea Luxembourg Malaysia Netherlands New Zealand Norway Romania Russia Scotland Spain Sweden Thailand Turkey U.K. (England, Wales & N Ireland) United States Uruguay
Spain Sweden Austria Luxembourg Finland Belgium, Dutch sp. Belgium, French sp. Netherlands France Canada Hong Kong Scotland Jalisco (Mexico) Australia Denmark Iceland Germany New Zealand UK^ Hungary Uruguay Rep. of Korea Italy Greece Croatia Chile Malaysia
2002
2003
2004
2005
2006
292 387 3 377 350 . 348 139 118 267 273 378 . 229 151 313 172 237 178 . 170 . 58 341 283 466 . 19 330 . 397 23 38 . 423 120
300 447 3 391 377 27 368 152 134 276 288 391 . 239 162 314 195 242 184 . 177 . 56 358 291 489 . 22 345 . 411 34 43 . 443 134
311 464 3 403 391 32 381 156 154 317 304 409 . 258 170 342 211 250 263 . 183 488 62 377 300 513 . 23 348 522 425 25 47 . 464 151
321 429 4 405 407 33 395 157 166 . 314 418 391 288 181 366 215 283 196 315 188 396 63 397 302 525 15 25 354 386 439 25 21 314 484 132
332 443 4 426 425 32 . 165 . . 325 435 409 306 190 387 240 319 . 352 196 435 65 420 303 537 20 29 360 482 453 20 58 290 506 210
Turkey Bosnia/Herzegov. Russia Thailand Romania Bangladesh 0
150
300
450
600
Rate per million population
figure 12.6 & table 12.e Reported prevalent rates of functioning grafts are greatest in Norway and the United States, at 537 and 506 per million population in 2006, respectively. Other countries and regions reporting rates greater than 400 per million population include Spain, Sweden, Austria, Luxembourg, Finland, Belgium (both Dutch- and French-speaking), the Netherlands, and France. Bosnia and Herzogovina, Russia, Thailand, and Romania each report rates of 20–32, while Bangladesh reports only 4 functioning grafts per million population.
12.7
2008 USRDS ANNUAL DATA REPORT
international comparisons
IIESRD
Transplant rates II
12
transplantation
II
12.f
Transplant rates, 2006
Transplant rates, by year (per million population)
United States Spain
Argentina Australia Austria Bangladesh Belgium, Dutch speaking Belgium, French speaking Bosnia & Herzegovina Canada Chile Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary Iceland Israel Italy Jalisco (Mexico) Rep. of Korea Luxembourg Malaysia Netherlands New Zealand Norway Philippines Romania Russia Scotland Spain Sweden Turkey U.K. (England, Wales & N Ireland) United States Uruguay
Jalisco (Mexico) Austria Norway Israel Uruguay Czech Republic Netherlands Sweden Finland Belgium, Dutch sp. Luxembourg France Belgium, French sp. Germany Canada Denmark Australia Hungary Italy Iceland Scotland Croatia Greece New Zealand Argentina Rep. of Korea Chile UK^ Turkey Hong Kong Philippines
2002
2003
2004
2005
2006
. 30.8 45.1 0.4 31.1 32.2 . 34.6 16.6 18.3 32.5 31.8 32.9 . 28.2 20.0 12.0 29.7 0.0 42.2 25.6 44.5 15.2 11.4 6.7 36.4 29.7 46.9 3.7 . 3.2 29.5 . 34.6 8.1 . 54.7 27.1
. 27.3 43.6 0.4 37.3 36.5 6.5 33.1 19.8 18.0 40.4 32.7 31.3 . 30.5 21.7 7.5 30.0 3.5 36.8 25.7 46.6 16.5 37.5 5.9 38.6 27.7 52.8 4.9 . 2.3 30.3 . 39.0 8.0 . 55.3 20.9
. 32.3 43.6 0.4 31.5 29.8 7.6 32.1 16.9 26.4 41.6 35.0 37.1 . 30.0 19.0 7.4 29.2 10.3 37.3 30.1 56.5 17.4 37.2 7.1 42.1 25.9 57.7 5.6 . 2.0 25.8 59.0 41.5 9.2 . 57.7 31.8
18.8 30.6 45.9 0.4 26.9 37.8 3.1 32.4 17.2 22.3 38.0 31.4 31.8 61.9 32.9 23.6 8.6 31.5 33.7 43.6 30.5 55.7 15.5 51.1 4.9 43.5 22.7 49.5 7.5 4.7 2.8 26.7 67.3 43.3 4.5 18.8 58.8 35.4
21.7 31.1 47.9 0.3 39.5 35.3 2.9 . 18.5 . 41.6 32.0 39.7 39.0 33.7 21.8 9.6 31.1 26.3 44.4 . 52.2 18.8 39.1 4.5 41.4 21.7 45.3 8.0 5.3 2.9 26.0 60.2 40.3 11.6 17.5 60.3 42.8
Romania Malaysia Russia Bosnia/Herzegov. Bangladesh 0
25
50
75
Rate per million population
all figures & tables data presented only for those countries from which relevant information was available; “.” signifies data not reported. All rates are unadjusted. ^UK: England, Wales, & Northern Ireland (Scotland data reported separately). Data from Argentina, Czech Republic, Israel, Japan, Luxembourg, Shanghai, & Taiwan are dialysis only. Latest data for Canada, Croatia, & Italy are for 2005. Data for France include 13 regions in 2005 & 15 regions in 2006.
figure 12.7 & table 12.f Spain and the United States each report a transplant rate of 60 per million population in 2006. The reported rate is less than 10 per million population, in contrast, in Hong Kong, the Philippines, Romania, Malaysia, Russia, Bosnia and Herzogivina, and Bangladesh.
S305
ARCTIC OCEAN
Canada
S306
United States PACIFIC ATLANTIC Tropic of Cancer
103
132
Jalisco
159
203
Equator
OCEAN OCEAN Tropic of Capricorn
Chile Argentina Uruguay
II
12.8
Incident rates of ESRD per million population, 2006 Antarctic Circle
data presented only for those countries from which relevant information was available. All rates are unadjusted. Data from Argentina, Czech Republic, Israel, Japan, Luxembourg, Shanghai, & Taiwan are dialysis only. Latest data for Canada, Croatia, & Italy are for 2005. Data for France include 15 regions in 2006.
Antarctic Circle
2008 USRDS ANNUAL DATA REPORT
ARCTIC OCEAN
12
worldwide view of the incidence of end-stage renal disease international comparisons
IIESRD
Russia
S307 S. Korea
Turkey Israel
Iran
Japan Pakistan Taiwan
PACIFIC
Tropic of Cancer
Thailand
Norway Equator
Iceland Scotland
Sweden INDIAN Finland
Malaysia Equator
Denmark
OCEAN
Netherlands United Kingdom Germany Belgium Czech Republic Luxembourg Austria Hungary France Croatia Romania Italy Bos & Herz.
Tropic of Capricorn
Australia OCEAN
New Zealand
Spain Greece
Antarctic Circle
Antarctic Circle
chapter summary
S308
418 Taiwan
363
United States
346
Jalisco (Mexico)
Reported incidence of ESRD in 2006 (per million population; 12.a & 12.2)
57.5 49.9 44.3 42.5 42.4
Malaysia Jalisco Mexico United States Japan Taiwan
Proportion of incident patients with diabetes as a primary diagnosis (12.3)
1in10 Number of patients in Australia on home hemodialysis (12.d & 12.5)
2226 1956 1641 Taiwan
Japan
U.S.
Reported prevalence of ESRD in 2006 (per million population; 12.c & 12.4)
45 16 39 HD
Home HD
PD
Distribution of patients in New Zealand, by modality, 2006 (12.d & 12.5)
210 2006
75%
120 2002
Rate of functioning grafts in Uruguay (12.e)
537
Norway
506
United States
Highest prevalent rates of functioning grafts reported for 2006 (12.6)
60.3 60.2 52.2 47.9 45.3
United States Spain Jalisco (Mexico) Austria Norway
Highest rates of transplant reported for 2006 (12.7)
Home, I said In every language there is a word for it. In the body itself, climbing those walls of white thunder, past those green temples, there is also a word for it. I said, home.
Mary Oliver, “The River”
Chapter
American Journal of Kidney Diseases, Vol 53, No 1, Suppl 1 (January, 2009), pp S297–S308.
We are pleased this year to present data from 44 regions and countries, again offering a worldwide picture of ESRD and the ways in which practitioners choose to treat it. This year we update our figures comparing the incidence and prevalence of ESRD around the world. As reported in 2005, Taiwan (whose data include only dialysis patients), the United States, and Jalisco (Mexico) again report the highest rates of incident ESRD at 418, 363, and 346 per million population, respectively. Iceland, Iran, Romania, the Philippines, and Finland, in contrast, report rates of 59–84, while reported rates are lowest in Bangladesh, Russia, and Pakistan, at 9, 28, and 29 per million population, respectively. Diabetes as a primary cause of ESRD accounts for a large proportion of incident ESRD patients. Malaysia, for example, reports a 2006 incident rate of 119 per million population— and nearly 58 percent of these patients have diabetes. Jalisco, the United States, Japan, Taiwan, the Republic of Korea, New Zealand, Hong Kong, and Israel all report rates of diabetes exceeding 40 percent. Prevalent rates for 2006 were highest in Taiwan and Japan (dialysis only), at 2,226 and 1,956 per million population, respectively, followed by the United States and Germany at 1,641, and 1,114. And reported rates for Jalisco have more than doubled in a span of four years, increasing from 394 in 2003 to 929 per million in 2006. Hemodialysis is the most common mode of dialysis therapy world-wide, evidenced by data showing that, in
over 60 percent of reporting countries, at least 80 percent of patients are on this mode of therapy. This is not the case, however, in countries such as Hong Kong and Jalisco, where peritoneal dialysis is provided to 81 and 71 percent of patients, respectively. And home hemodialysis therapy is provided to nearly 10 percent of patients in Australia and to 16 percent of patients in New Zealand. Renal transplant rates are many times a reflection not only of a country’s health-care system, but of cultural diversities as well. Transplant rates, for example, are less than 10 per million population in countries such as Hong Kong, the Philippines, Romania, and Malaysia, in contrast to rates exceeding 60 per million in Spain and the United States. Rates of functioning grafts reach 506 and 537 per million, respectively, in the United States and Norway, but are less than 30 per million in Russia, Thailand, Romania, and Bangladesh. We invite all renal registries to send their data, using the form provided on page 243. You may return it to us by email or fax: [email protected], and 1.612.347.5878. We wish to thank all participating registries for their willingness to provide data on their ESRD programs and help us give a perspective on patients with ESRD worldwide.
II
12.1
Comparison of ESRD incidence & prevalence worldwide
450
Incidence
2,400
Taiwan
Prevalence Taiwan
2,200 400 2,000
United States
Japan 1,800
300
250 Japan
Germany Israel
200
Rep. of Korea
150
Prevalent rate per million population
Incident rate per million population
350
United States 1,600
1,400
Australia Norway Rep. of Korea Sweden
1,200
1,000
Germany
uay Urug 800
Uruguay 600
Sweden
Malaysia
Israel
100 Norway
400
Australia
Malaysia 50
Jalisco (Mexico) 200
1999
2000
2001
2002
2003
2004
2005
2006
1999
2000
2001
2002
2003
2004
2005
2006
figure 12.1 all rates are unadjusted. Data from Israel, Japan, & Taiwan are dialysis only. Incident data for Jalisco not shown due to high year-to-year variability.
highlights figure 12.3 & table 12.b Diabetes was the primary cause of ESRD in 58 percent of new patients in Malaysia in 2006, and 50 percent of those in Jalisco (Mexico). In a majority of reporting countries, 20–44 percent of new patients have this primary diagnosis. figure 12.6 & table 12.e Reported prevalent rates of functioning grafts are greatest in Norway and the United States, at 537 and 506 per million population in 2006, respectively.
contents incidence of ESRD · S300 overall incident rates ESRD due to diabetes prevalence of ESRD · S302 overall prevalent rates dialysis · S303 patient distribution, by modality transplantation · S304 rates of functioning grafts transplant rates worldwide view of the incidence of ESRD · S306 international maps
Incidence of end-stage renal disease II
12.2
S300
Incidence of ESRD, 2006
Taiwan United States Jalisco (Mexico) Shanghai Japan Luxembourg Germany Israel Greece Turkey Belgium, Dutch sp. Belgium, French sp. Rep. of Korea Czech Republic Canada Hungary Austria Croatia Uruguay Argentina Chile Hong Kong France Thailand Bosnia/Herzegov. Spain Sweden Italy Malaysia New Zealand Australia Scotland Denmark Netherlands UK^ Norway Finland Philippines Romania Iran Iceland Pakistan Russia Bangladesh 0 150 300 450 Rate per million population
II
12.a
Incidence of ESRD, by year (per million population)
Australia Argentina Austria Bangladesh Belgium, Dutch speaking Belgium, French speaking Bosnia & Herzegovina Canada Chile Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary Iceland Iran Israel Italy Jalisco (Mexico) Japan Luxembourg Malaysia Netherlands New Zealand Norway Pakistan Philippines Rep. of Korea Romania Russia Scotland Shanghai Spain Sweden Taiwan Thailand Turkey U.K. (England, Wales, & N Ireland) United States Uruguay
2002
2003
2004
2005
2006
97 . 135 6 174 173
100 . 140 8 175 161 106 162 130 131 167 132 95 . 186 180 128 139 73 61 199 133 280 263 180 102 103 115 96 32 60 152 . 19 121 232 . 122 391 78 112 . 342 146
97 137 160 7 181 187 108 163 157 155 166 133 97 . 194 196 135 139 79 71 201 161 346 267 188 110 106 113 101 . 75 171 . 17 115 263 175 122 397 123 121 . 346 151
112 140 153 9 183 177 104 163 135 144 175 122 96 139 203 193 137 162 64 72 197 121 302 271 164 103 107 112 99 22 79 173 94 24 123 275 126 120 434 110 179 108 353 146
115 141 158 9 192 186 133 . 141 . 173 113 84 140 213 196 140 159 59 66 203 . 346 275 224 119 112 117 100 29 80 185 75 28 115 282 132 127 418 139 192 103 363 142
158 127 118 159 132 94 . 174 168 129 123 73 . 166 126 232 256 144 97 102 119 93 26 53 129 . 15 110 156 . 129 395 . 118 . 338 136
figure 12.2 & table 12.a Incident rates of reported ESRD are greatest in Taiwan (dialysis only), at 418 per million population in 2006, followed by the United States, Jalisco (Mexico), Shanghai, and Japan. Rates of 100 per million population or lower are reported by Bangladesh, Russia, Pakistan, Iceland, Iran, Romania, the Philippines, Finland, and Norway. It is important to note the distinction between the incidence of treatment, guided by available funding, and the incidence of a disease itself. An affluent nation may allow elderly patients and those with diabetes to receive hemodialysis, while developing nations may restrict this treatment to younger, healthier patients.
12.3
Percentage of incident patients with ESRD due to diabetes, 2006
II
12.b
2008 USRDS ANNUAL DATA REPORT
Percentage of incident patients with ESRD due to diabetes, by year
Malaysia Jalisco (Mexico)
Argentina Australia Austria Belgium, Dutch speaking Belgium, French speaking Bosnia & Herzegovina Canada Croatia Denmark Finland France Germany Greece Hong Kong Hungary Iceland Israel Italy Jalisco (Mexico) Japan Luxembourg Malaysia Netherlands New Zealand Norway Pakistan Philippines Rep. of Korea Romania Russia Scotland Spain Sweden Taiwan Turkey U.K. (England, Wales, & N Ireland) United States Uruguay
United States Japan Taiwan Rep. of Korea New Zealand Hong Kong Israel Philippines Pakistan Finland France Germany Argentina Iceland Austria Australia Greece Luxembourg Hungary Sweden Denmark Spain Turkey Belgium, French sp. Belgium, Dutch sp. Scotland Bosnia/Herzegov. UK^ Uruguay Norway Netherlands Russia Romania 0
15 30 45 60 Percent of patients
all figures & tables data presented only for those countries from which relevant information was available; “.” signifies data not reported. All rates are unadjusted. ^UK: England, Wales, & Northern Ireland (Scotland data reported separately). Data from Argentina, Czech Republic, Israel, Japan, Luxembourg, Shanghai, & Taiwan are dialysis only. Latest data for Canada, Croatia, & Italy are for 2005. Data for France include 13 regions in 2005 & 15 regions in 2006.
international comparisons
IIESRD
End-stage renal disease due to diabetes II
12
incidence of end-stage renal disease
2002
2003
2004
2005
2006
. 26.7 34.5 22.4 22.5 . 33.6 28.8 26.3 39.1 . 36.2 26.8 47.0 26.2 9.5 39.3 16.3 51.0 38.7 . 49.1 17.4 44.5 11.9 40.0 28.5 40.7 . 9.0 18.5 . 23.8 38.9 46.2 . 44.8 20.0
. 26.0 33.5 24.0 25.0 22.9 34.2 26.9 22.6 34.9 . 36.3 28.0 39.9 25.5 0.0 37.6 16.2 51.0 40.6 . 51.7 16.6 41.3 15.8 40.0 32.8 42.5 . 10.7 18.9 . 24.0 36.8 23.1 . 44.9 29.6
31.4 30.3 32.6 24.4 21.3 20.1 34.3 29.0 21.7 33.3 . 34.2 28.3 40.5 29.5 4.3 40.7 16.2 56.0 40.9 . 54.7 17.3 40.5 17.3 . 33.5 43.4 . . 17.8 17.5 24.9 38.0 21.3 . 45.0 21.8
34.7 31.4 33.6 24.0 23.7 20.6 34.9 30.0 24.1 34.6 23.3 34.9 29.4 42.0 26.2 15.8 38.7 18.0 60.0 41.6 . 52.0 15.6 41.8 12.9 36.3 36.9 38.5 10.7 11.0 21.9 23.2 25.8 40.7 30.2 19.0 44.4 29.6
33.8 32.4 32.9 22.2 22.5 21.5 . . 24.0 35.4 34.7 34.4 29.5 41.0 27.5 33.3 40.4 . 49.9 42.5 28.2 57.5 16.0 41.7 16.4 37.7 38.5 42.3 12.4 13.9 22.0 23.1 26.0 42.4 23.1 18.6 44.3 17.4
figure 12.3 & table 12.b Diabetes was the primary cause of ESRD in 58 percent of new patients in Malaysia in 2006, and 50 percent of those in Jalisco (Mexico). In a majority of reporting countries, 20–44 percent of new patients have this primary diagnosis. Countries with the lowest reported rates of ESRD due to diabetes include Romania, Russia, the Netherlands, Norway, Uruguay, and the United Kingdom (England, Wales, and Northern Ireland), each with 12–19 percent.
S301
Prevalence of end-stage renal disease II
12.4
S302
II
12.c
Prevalence of ESRD, 2006
Prevalence of ESRD, by year (per million population) Prevalent counts 2002 2003
Taiwan Japan United States Germany Belgium, French sp. Belgium, Dutch sp. Hong Kong Spain Greece France Rep. of Korea Chile Jalisco (Mexico) Uruguay Austria Sweden Denmark New Zealand Australia Scotland Netherlands Norway Finland Hungary UK^ Israel Malaysia Argentina Turkey Bosnia/Herzegov. Luxembourg Iceland Czech Republic Shanghai Romania Thailand Russia Bangladesh Philippines
Argentina Australia Austria Bangladesh Belgium, Dutch sp. Belgium, French sp. Bosnia & Herzegov. Canada Chile Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary Iceland Israel Italy Jalisco (Mexico) Japan Luxembourg Malaysia Netherlands New Zealand Norway Philippines Rep. of Korea Romania Russia Scotland Shanghai Spain Sweden Taiwan Thailand Turkey U.K. United States Uruguay 0
600
1,200 1,800 2,400
Rate per million population
. 13,017 6,303 8,265 5,260 3,850 . 28,222 11,314 3,100 7,092 3,851 3,305 . 75,777 9,266 5,670 6,060 125 3,796 48,977 2,432 220,196 199 10,531 10,594 2,715 2,917 1,853 33,993 . 11,517 3,457 . . 6,823 40,362 . 26,268 . 420,399 2,715
. 13,691 6,940 9,220 5,464 4,068 1,829 29,522 12,190 3,504 7,227 4,004 3,461 . 78,281 9,705 5,937 6,743 139 4,039 51,281 2,463 229,446 200 9,807 11,008 2,883 3,049 3,922 38,790 . 13,175 3,607 . . 6,972 42,945 15,004 28,549 . 437,652 2,675
2004
2005
21,034 14,259 7,345 10,274 5,733 4,342 1,867 31,025 13,450 3,582 7,743 4,157 3,598 . 82,305 10,199 6,274 6,310 140 4,267 59,185 3,170 236,606 209 13,348 11,455 2,996 3,255 4,375 41,891 . 14,720 3,693 . 39,578 7,211 45,710 15,083 31,251 . 455,181 2,895
22,333 15,136 7,244 11,565 6,022 4,523 2,009 32,493 14,160 3,708 4,638 4,245 3,748 31,557 87,151 10,637 6,571 5,901 143 4,439 44,387 5,455 240,513 224 14,628 11,980 3,110 3,386 7,288 44,333 5,504 16,483 3,844 . 28,366 7,394 48,685 13,741 33,014 37,962 473,472 2,807
Prevalent rates 2006 2002 2003 2004 2005 2006 23,306 . . 550 16,027 663 689 709 7,544 782 859 906 12,864 65 72 73 6,325 879 910 951 4,774 885 933 989 2,115 . 477 487 . 900 933 971 15,353 726 773 841 . 699 790 807 4,752 695 708 758 4,307 716 743 770 3,807 636 664 688 34,648 . . . 91,718 920 948 998 10,968 842 881 922 6,866 843 878 923 6,976 601 667 622 147 435 480 479 4,632 578 604 627 . 854 886 1,022 6,357 389 394 508 249,957 1,727 1,797 1,852 240 452 444 486 16,372 429 400 522 12,617 656 678 704 3,224 689 719 738 3,508 643 668 709 7,643 22 46 52 46,730 701 794 854 6,573 . . . 18,486 79 91 102 3,966 684 713 727 . 286 327 364 35,503 . . 1,098 7,677 764 778 802 50,920 1,792 1,900 2,015 17,967 . 235 243 42,992 374 419 433 36,577 . . . 493,624 1,452 1,498 1,543 3,073 807 846 893
figure 12.4 & table 12.c Taiwan (dialysis only) continues to report the greatest prevalent rates of ESRD, at 2,226 per million population in 2006. The next highest rates are reported by Japan and the United States, at 1,956 and 1,641. The lowest rates, of 88 and 92 per million population, are reported by the Philippines and Bangladesh.
579 745 891 83 994 1,024 524 1,007 866 836 452 783 714 932 1,057 958 961 590 482 641 755 808 1,882 498 560 734 759 732 87 900 254 115 754 404 868 819 2,138 220 451 689 1,589 849
598 778 912 92 1,037 1,073 552 . 930 . 462 792 723 957 1,114 984 994 699 484 657 . 929 1,956 522 615 772 779 753 88 942 304 130 775 447 991 845 2,226 286 589 659 1,641 927
12.5
Percent distribution of prevalent dialysis patients, by modality, 2006
Luxembourg Bangladesh Japan Argentina Thailand Bosnia/Herzegov. Chile Philippines Germany Uruguay Taiwan Czech Republic United States Israel Greece Russia Austria Croatia Malaysia Belgium, French sp. Belgium, Dutch sp. Turkey Spain Hungary Italy Romania France Norway Canada UK^ Rep. of Korea Scotland Finland Sweden Netherlands Denmark Iceland Australia New Zealand Jalisco (Mexico) Hong Kong
In-center HD Home HD CAPD/CCPD
0
20 40 60 80 100 Percent of patients
all figures & tables data presented only for those countries from which relevant information was available; “.” signifies data not reported. All rates are unadjusted. ^UK: England, Wales, & Northern Ireland (Scotland data reported separately). Data from Argentina, Czech Republic, Israel, Japan, Luxembourg, Shanghai, & Taiwan are dialysis only. Latest data for Canada, Croatia, & Italy are for 2005. Data for France include 13 regions in 2005 & 15 regions in 2006.
II
12.d
2008 USRDS ANNUAL DATA REPORT
international comparisons
IIESRD
Patient distribution, by type of dialysis II
12
prevalence of end-stage renal disease; dialysis
Percent distribution of prevalent dialysis patients, by modality & year Hemodialysis Home hemodialysis Peritoneal dialysis 2002 2003 2004 2005 2006 2002 2003 2004 2005 2006 2002 2003 2004 2005 2006
Argentina Australia Austria Bangladesh Belg/Dutch sp. Belgium/Fr. sp. Bosnia/Herz. Canada Chile Croatia Czech Rep. Denmark Finland France Germany Greece Hong Kong Hungary Iceland Israel Italy Jalisco (Mexico) Japan Rep. of Korea Luxembourg Malaysia Netherlands New Zealand Norway Philippines Romania Russia Scotland Spain Sweden Taiwan Thailand Turkey UK^ United States Uruguay
. 64.7 92.0 99.1 89.7 90.3 . 78.7 95.3 91.5 92.8 74.3 78.2 . 93.8 90.0 17.9 92.7 66.7 84.7 89.3 18.0 96.2 77.8 99.0 87.5 68.3 37.5 84.0 91.2 . 93.5 75.6 . 73.5 93.9 . 86.9 . 91.2 93.7
. 66.1 92.0 99.0 89.5 90.3 96.6 79.4 94.3 92.0 92.6 72.8 75.5 . 94.1 90.3 17.4 92.1 66.2 88.6 89.6 20.0 96.3 77.4 99.5 88.3 69.5 41.2 83.6 100 . 92.5 77.4 . 74.2 93.5 92.3 87.5 . 91.3 93.0
95.6 67.6 92.3 98.8 88.5 89.8 96.2 79.1 94.0 91.1 92.5 72.9 75.5 . 94.1 90.6 17.4 93.4 59.1 89.0 87.2 30.1 96.3 77.0 99.5 89.1 72.2 43.2 82.9 85.5 . 91.9 77.3 88.6 74.7 93.4 93.2 88.2 . 91.6 92.3
96.0 69.1 92.1 98.6 88.8 89.6 95.7 78.9 94.3 90.8 92.5 72.2 75.4 86.1 93.9 91.0 17.0 87.2 64.4 90.9 87.0 28.3 96.3 77.7 99.6 89.8 73.4 45.8 83.2 87.9 81.9 91.5 77.7 90.6 75.8 93.0 93.9 87.9 77.5 91.8 92.3
96.0 68.4 90.9 99.6 89.1 89.1 95.3 . 95.0 . 92.4 72.2 75.8 80.5 93.8 91.5 18.7 87.3 70.6 91.9 . 29.5 96.5 78.4 100 90.0 74.8 45.1 80.4 94.5 80.7 91.0 78.4 88.6 75.4 92.4 95.8 88.7 78.7 91.9 92.6
. 10.7 0.3 0.0 0.1 1.0 . 1.5 0.02 0.0 0.02 1.1 2.9 . 0.90 0.01 0.17 0.0 0.0 0.0 0.0 0.0 0.03 0.0 0.5 2.4 1.8 14.4 0.3 0.0 . 0.0 2.5 . 2.3 0.0 . 0.0 . 0.6 0.0
. 10.1 0.2 0.0 0.1 1.2 0.0 1.7 0.02 0.0 0.02 1.6 3.2 . 0.83 0.14 0.14 0.0 0.0 0.0 0.0 0.0 0.04 0.0 0.5 2.1 2.0 14.0 0.2 0.0 . 0.0 2.4 . 2.3 0.0 0.0 0.0 . 0.6 0.0
0.0 10.0 0.2 0.0 0.2 1.2 0.0 2.0 0.02 0.0 0.02 2.3 3.5 . 0.79 0.03 0.03 0.0 1.5 0.0 0.8 0.0 0.04 0.0 0.5 1.5 2.1 14.8 0.2 0.0 . 0.0 2.3 0.0 2.9 0.0 0.0 0.0 . 0.6 0.0
0.0 9.4 0.2 0.0 0.2 1.2 0.0 2.5 0.02 0.0 0.02 3.0 3.2 2.4 0.83 0.03 0.0 0.0 0.0 0.0 0.7 0.0 0.05 0.0 0.4 1.3 2.0 15.8 0.5 0.0 0.0 0.0 2.1 0.0 3.1 0.0 0.0 0.0 2.2 0.7 0.0
0.0 9.5 0.2 0.0 0.2 1.3 0.0 . 0.02 . 0.00 3.8 3.0 7.5 0.85 0.05 0.0 0.0 0.0 0.0 . 0.0 0.06 0.0 0.0 1.1 2.2 16.2 0.4 0.0 0.0 0.0 1.7 0.1 2.6 0.0 0.0 0.0 2.0 0.7 0.0
. 24.6 7.7 0.9 10.2 8.7 . 19.8 4.7 8.5 7.2 24.7 18.9 . 5.3 10.0 81.9 7.3 33.3 15.3 10.7 82.0 3.8 22.2 0.5 10.1 29.9 48.1 15.7 8.8 . 6.5 21.9 . 24.2 6.1 . 13.1 . 8.2 6.3
figure 12.5 & table 12.d In Hong Kong, 81 percent of patients were treated with CAPD/CCPD in 2006, the highest reported rate worldwide. The therapy is also widely used in Jalisco (Mexico), at 70 percent, and in New Zealand and Iceland, at 39 and 29 percent, respectively. Fewer than 5 percent of patients, in contrast, are treated with peritoneal dialysis in Luxembourg, Bangladesh, Japan, Argentina, Thailand, and Bosnia and Herzogovina. Reported use of home hemodialysis is greatest in New Zealand and Australia, at 16 and 9.5 percent.
. 23.8 7.8 1.0 10.4 8.5 3.4 18.9 5.7 8.0 7.4 25.7 21.3 . 5.1 9.7 82.5 7.9 33.8 11.4 10.4 80.0 3.7 22.6 0.0 9.6 28.5 44.8 16.1 0.0 . 7.5 20.2 . 23.5 6.5 7.7 12.5 . 8.1 7.0
4.4 22.4 7.5 1.2 11.3 9.0 3.8 18.9 6.0 8.9 7.5 24.8 21.0 . 5.1 9.4 82.6 6.6 39.4 11.0 12.0 69.9 3.6 23.0 0.0 9.4 25.7 41.9 16.9 14.5 . 8.1 20.4 11.4 22.4 6.6 6.8 11.8 . 7.8 7.7
4.0 21.5 7.7 1.4 11.1 9.2 4.3 18.7 5.6 9.2 7.5 24.8 21.4 11.5 5.2 9.0 83.0 12.8 35.6 9.1 12.3 71.7 3.6 22.3 0.0 8.8 24.5 38.4 16.2 12.1 18.1 8.5 20.2 9.4 21.1 7.0 6.1 12.1 20.3 7.6 7.7
4.0 22.0 9.0 0.4 10.7 9.6 4.7 . 5.0 . 7.6 24.0 21.3 12.0 5.3 8.5 81.3 12.7 29.4 8.1 . 70.5 3.4 21.6 0.0 8.9 23.0 38.8 19.2 5.5 19.3 9.0 19.8 11.3 22.0 7.6 4.2 11.3 19.3 7.4 7.4
S303
Prevalent rates of functioning grafts II
12.6
II
12.e
Prevalent rates of functioning grafts, 2006
Prevalent rates of functioning grafts, by year (per million population)
Norway
S304
United States
Australia Austria Bangladesh Belgium, Dutch speaking Belgium, French speaking Bosnia & Herzegovina Canada Chile Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary Iceland Italy Jalisco (Mexico) Rep. of Korea Luxembourg Malaysia Netherlands New Zealand Norway Romania Russia Scotland Spain Sweden Thailand Turkey U.K. (England, Wales & N Ireland) United States Uruguay
Spain Sweden Austria Luxembourg Finland Belgium, Dutch sp. Belgium, French sp. Netherlands France Canada Hong Kong Scotland Jalisco (Mexico) Australia Denmark Iceland Germany New Zealand UK^ Hungary Uruguay Rep. of Korea Italy Greece Croatia Chile Malaysia
2002
2003
2004
2005
2006
292 387 3 377 350 . 348 139 118 267 273 378 . 229 151 313 172 237 178 . 170 . 58 341 283 466 . 19 330 . 397 23 38 . 423 120
300 447 3 391 377 27 368 152 134 276 288 391 . 239 162 314 195 242 184 . 177 . 56 358 291 489 . 22 345 . 411 34 43 . 443 134
311 464 3 403 391 32 381 156 154 317 304 409 . 258 170 342 211 250 263 . 183 488 62 377 300 513 . 23 348 522 425 25 47 . 464 151
321 429 4 405 407 33 395 157 166 . 314 418 391 288 181 366 215 283 196 315 188 396 63 397 302 525 15 25 354 386 439 25 21 314 484 132
332 443 4 426 425 32 . 165 . . 325 435 409 306 190 387 240 319 . 352 196 435 65 420 303 537 20 29 360 482 453 20 58 290 506 210
Turkey Bosnia/Herzegov. Russia Thailand Romania Bangladesh 0
150
300
450
600
Rate per million population
figure 12.6 & table 12.e Reported prevalent rates of functioning grafts are greatest in Norway and the United States, at 537 and 506 per million population in 2006, respectively. Other countries and regions reporting rates greater than 400 per million population include Spain, Sweden, Austria, Luxembourg, Finland, Belgium (both Dutch- and French-speaking), the Netherlands, and France. Bosnia and Herzogovina, Russia, Thailand, and Romania each report rates of 20–32, while Bangladesh reports only 4 functioning grafts per million population.
12.7
2008 USRDS ANNUAL DATA REPORT
international comparisons
IIESRD
Transplant rates II
12
transplantation
II
12.f
Transplant rates, 2006
Transplant rates, by year (per million population)
United States Spain
Argentina Australia Austria Bangladesh Belgium, Dutch speaking Belgium, French speaking Bosnia & Herzegovina Canada Chile Croatia Czech Republic Denmark Finland France Germany Greece Hong Kong Hungary Iceland Israel Italy Jalisco (Mexico) Rep. of Korea Luxembourg Malaysia Netherlands New Zealand Norway Philippines Romania Russia Scotland Spain Sweden Turkey U.K. (England, Wales & N Ireland) United States Uruguay
Jalisco (Mexico) Austria Norway Israel Uruguay Czech Republic Netherlands Sweden Finland Belgium, Dutch sp. Luxembourg France Belgium, French sp. Germany Canada Denmark Australia Hungary Italy Iceland Scotland Croatia Greece New Zealand Argentina Rep. of Korea Chile UK^ Turkey Hong Kong Philippines
2002
2003
2004
2005
2006
. 30.8 45.1 0.4 31.1 32.2 . 34.6 16.6 18.3 32.5 31.8 32.9 . 28.2 20.0 12.0 29.7 0.0 42.2 25.6 44.5 15.2 11.4 6.7 36.4 29.7 46.9 3.7 . 3.2 29.5 . 34.6 8.1 . 54.7 27.1
. 27.3 43.6 0.4 37.3 36.5 6.5 33.1 19.8 18.0 40.4 32.7 31.3 . 30.5 21.7 7.5 30.0 3.5 36.8 25.7 46.6 16.5 37.5 5.9 38.6 27.7 52.8 4.9 . 2.3 30.3 . 39.0 8.0 . 55.3 20.9
. 32.3 43.6 0.4 31.5 29.8 7.6 32.1 16.9 26.4 41.6 35.0 37.1 . 30.0 19.0 7.4 29.2 10.3 37.3 30.1 56.5 17.4 37.2 7.1 42.1 25.9 57.7 5.6 . 2.0 25.8 59.0 41.5 9.2 . 57.7 31.8
18.8 30.6 45.9 0.4 26.9 37.8 3.1 32.4 17.2 22.3 38.0 31.4 31.8 61.9 32.9 23.6 8.6 31.5 33.7 43.6 30.5 55.7 15.5 51.1 4.9 43.5 22.7 49.5 7.5 4.7 2.8 26.7 67.3 43.3 4.5 18.8 58.8 35.4
21.7 31.1 47.9 0.3 39.5 35.3 2.9 . 18.5 . 41.6 32.0 39.7 39.0 33.7 21.8 9.6 31.1 26.3 44.4 . 52.2 18.8 39.1 4.5 41.4 21.7 45.3 8.0 5.3 2.9 26.0 60.2 40.3 11.6 17.5 60.3 42.8
Romania Malaysia Russia Bosnia/Herzegov. Bangladesh 0
25
50
75
Rate per million population
all figures & tables data presented only for those countries from which relevant information was available; “.” signifies data not reported. All rates are unadjusted. ^UK: England, Wales, & Northern Ireland (Scotland data reported separately). Data from Argentina, Czech Republic, Israel, Japan, Luxembourg, Shanghai, & Taiwan are dialysis only. Latest data for Canada, Croatia, & Italy are for 2005. Data for France include 13 regions in 2005 & 15 regions in 2006.
figure 12.7 & table 12.f Spain and the United States each report a transplant rate of 60 per million population in 2006. The reported rate is less than 10 per million population, in contrast, in Hong Kong, the Philippines, Romania, Malaysia, Russia, Bosnia and Herzogivina, and Bangladesh.
S305
ARCTIC OCEAN
Canada
S306
United States PACIFIC ATLANTIC Tropic of Cancer
103
132
Jalisco
159
203
Equator
OCEAN OCEAN Tropic of Capricorn
Chile Argentina Uruguay
II
12.8
Incident rates of ESRD per million population, 2006 Antarctic Circle
data presented only for those countries from which relevant information was available. All rates are unadjusted. Data from Argentina, Czech Republic, Israel, Japan, Luxembourg, Shanghai, & Taiwan are dialysis only. Latest data for Canada, Croatia, & Italy are for 2005. Data for France include 15 regions in 2006.
Antarctic Circle
2008 USRDS ANNUAL DATA REPORT
ARCTIC OCEAN
12
worldwide view of the incidence of end-stage renal disease international comparisons
IIESRD
Russia
S307 S. Korea
Turkey Israel
Iran
Japan Pakistan Taiwan
PACIFIC
Tropic of Cancer
Thailand
Norway Equator
Iceland Scotland
Sweden INDIAN Finland
Malaysia Equator
Denmark
OCEAN
Netherlands United Kingdom Germany Belgium Czech Republic Luxembourg Austria Hungary France Croatia Romania Italy Bos & Herz.
Tropic of Capricorn
Australia OCEAN
New Zealand
Spain Greece
Antarctic Circle
Antarctic Circle
chapter summary
S308
418 Taiwan
363
United States
346
Jalisco (Mexico)
Reported incidence of ESRD in 2006 (per million population; 12.a & 12.2)
57.5 49.9 44.3 42.5 42.4
Malaysia Jalisco Mexico United States Japan Taiwan
Proportion of incident patients with diabetes as a primary diagnosis (12.3)
1in10 Number of patients in Australia on home hemodialysis (12.d & 12.5)
2226 1956 1641 Taiwan
Japan
U.S.
Reported prevalence of ESRD in 2006 (per million population; 12.c & 12.4)
45 16 39 HD
Home HD
PD
Distribution of patients in New Zealand, by modality, 2006 (12.d & 12.5)
210 2006
75%
120 2002
Rate of functioning grafts in Uruguay (12.e)
537
Norway
506
United States
Highest prevalent rates of functioning grafts reported for 2006 (12.6)
60.3 60.2 52.2 47.9 45.3
United States Spain Jalisco (Mexico) Austria Norway
Highest rates of transplant reported for 2006 (12.7)