1. Section 1: CKD Epidemiology

2. The Problem Chronic Kidney Disease is an epidemic worldwide
Growth 6-8% per annum of dialysis patients
Accumulating data re: possibility of delaying the progression of kidney disease, using multiple drug and behaviour intervention therapies.
Under-recognition at earlier stages of kidney dysfunction persists
Late referral
Lost opportunities for improved patient outcomes

3. RRT Modalities
36,542
DOD/

4. Age Specific Rate per Million
Patients Accepted in the UK for Renal Replacement Therapy 50
100
150
200
250
300 80 81 82 83 84 85 86 87 88 90 91 92 93 94 95 96 97 98 99
2000
2001
Year
Age Specific Rate per Million
0 - 44
65+
Diabetics
Total

5. Cadaveric Kidney Donors & Transplants and End of Year Kidney Waiting List, UK, 1994-2003
DOD/

6. Prevalence of renal replacement therapy
Take-on rates /pmp
England 98
Wales
118
France
200
Italy
260
USA
315

7. Estimates of Prevalence of CKD in the US: NHANES III
Stage
Description
GFR
(ml/min/1.73 m2)
Prevalence
(000s)
(%) 1
Kidney Damage with Normal or  GFR
>90
5,900
3.3 2
Kidney Damage with
Mild  GFR
60-89
5,300
3.0 3
Moderate  GFR
30-59
7,600
4.3 4
Severe  GFR
15-29
400
0.2 5
Kidney Failure
<15 or
(or dialysis)
300
0.1
Using their definition and classification of stages of chronic kidney disease the K/DOQI workgroup was able to provide rough estimates of the prevalence of each stage in adults aged 20 or over from the Third National Health and Nutrition Examination Survey (NHANES III) in the United States.
In the United States, there is a rising incidence and prevalence of kidney failure. There is an even higher prevalence of earlier stages of CKD.
Adapted from Am J Kidney Dis 2002; 39 (2, Suppl. 1): S17-S31

8. NICE: 2008 Classification of CKD waking up to the impact of proteinuria
Stage 1: GFR>90 + abnormal urinalysis
Stage 2: GFR abnormal urinalysis
Stage 3A: GFR 45-59
Stage 3B: GFR 30-44
Stage 4: GFR 15-29
Stage 5: GFR <15 or dialysis dependent
Suffix P denotes presence of proteinuria (ACR>30 or PCR>50)

9. National Disease Prevalence Survey (%)

10. CKD: A Typical GP Practice of 100005 6 15 4 60
Stage of Kidney Disease 30
(GFR)
380 3 60 2
460 90 1

11. Incident Rates by Primary Diagnosis
(per million population, unadjusted)
Diabetes is the most rapidly rising cause of ESRD, but hypertension and glomerulonephritis rates also continue to rise.
USRDS, 2000

14. Obesity Trends: UK

15. Life expectancy: UK