1. CHAPTER 2 DIALYSIS IN MALAYSIA Goh Bak Leong Lim Yam Ngo Ong Loke Meng Ghazali Ahmad Lee Day Guat Source: 21 st MDTR Report 2013, NRR

2. Table 2.1.1(a): Stock and flow-Haemodialysis Patients 2004-2013 Year20042005200620072008200920102011 20122013 New haemodialysis patients 2610283932843554403543724715539457895491 Died1166133316431756191422792692291532013014 Transplanted1461009672909687 6454 Lost to Follow-up121335151025396461116 Dialysing at 31 st December 10718121811376115532176341969821703240982652528822

3. Source: 21 st MDTR Report 2013, NRR Table 2.1.1(b): Stock and flow- Chronic PD Patients 2004-2013 Year20042005200620072008200920102011 20122013 New chronic PD patients 291316397516569548537615752731 Died 156182177231277321353372397423 Transplanted 13222518211512171417 Lost to Follow-up 1435346306 Dialysing at 31 st Dec 1124117413171549175018861989217425462815

4. Source: 21 st MDTR Report 2013, NRR Table 2.1.1 (c): Haemodialysis Treatment Rate per million population 2004-2013 Year20042005200620072008200920102011 20122013 Acceptance rate101107122131147157167189197185 Prevalence rate414460513571640706768844904970

5. Source: 21 st MDTR Report 2013, NRR Table 2.1.1 (d): Chronic PD Treatment Rate per million population 2004-2013 Year2004200520062007200820092010201120122013 Acceptance rate 11121519212019222625 Prevalence rate 43444957646870768795

6. Source: 21 st MDTR Report 2013, NRR Table 2.1.2: Dialysis Treatment Rate by state, per million population 2004-2013 State20042005200620072008200920102011 20122013 Pulau Pinang 211196212216200248265303323303 Melaka 206167197207231227258314271291 Johor 155167214199255249240307297289 Perak 148168187181205222241258281257 Selangor & Putrajaya 123136155173182207230265266241 WP Kuala Lumpur 202191212245258281309290323326 Negeri Sembilan 155157151218251270279299309274 Kedah 98111119134173161160209233230 Perlis 94102127130141127142169163104 Terengganu 81105107179148157197196248255 Pahang 7590124119145142179182249191 Kelantan 6578 948511299124163130 Sarawak 737286106118123118130134 159 Sabah & WP Labuan 474561689694 104108 106

7. Source: 21 st MDTR Report 2013, NRR Table 2.1.3(a) : Dialysis Treatment Rate by Gender, per million male or female population 2004-2013 Gender20042005200620072008200920102011 20122013 Male 128139156171193205216242257242 Female 110111133144159169181207216207

8. Source: 21 st MDTR Report 2013, NRR Figure 2.1.3(a): Dialysis Treatment Rate by Gender 2004-2013 0 30 60 90 120 150 180 210 240 Treatment rate, per million population 2004200520062007200820092010201120122013 Year MaleFemale

9. Source: 21 st MDTR Report 2013, NRR Table 2.1.3(b): Gender Distribution of Dialysis Patients 2004-2013 Year20042005200620072008200920102011 20122013 New Dialysis patients 2901315536814070460449205252600965416222 % Male555755 56 55 5655 % Female454345 44 45 4445 Dialysing at 31 st December 1184213355 1507 8 1708119384 2158 4 236922627229071 3163 7 % Male5555.45554.85555.154.954.654.754.5 % Female4544.64545.24544.945.145.445.345.5

10. Source: 21 st MDTR Report 2013, NRR Figure 2.1.3(b): Gender Distribution of Dialysis Patients 2004-2013 (i) New Dialysis patients (ii) patients at 31st December 0 10 20 30 40 50 60 Proportion of patients 2004200520062007200820092010201120122013 Year MaleFemale 0 10 20 30 40 50 60 Proportion of patients 2004200520062007200820092010201120122013 Year MaleFemale

11. Source: 21 st MDTR Report 2013, NRR Table 2.1.4 (a): Dialysis Treatment Rate by Age Group, per million age group population 2004-2013 Age groups (years) 2004200520062007200820092010201120122013 ≤14 5656687766 15-24 273032 30353233 38 25-34 475160 707181848278 35-44 109104131119146134139154184179 45-54 300290452352393400419463522468 55-64 579641663759 8138619401038979 ≥ 65 65967381585397510321026119111751053

12. Source: 21 st MDTR Report 2013, NRR Figure 2.1.4 (a): Dialysis Treatment Rate by Age Group 2004-2013

13. Source: 21 st MDTR Report 2013, NRR Table 2.1.4 (b): Percentage Age Distribution of Dialysis Patients 2004-2013 Year20042005200620072008200920102011 20122013 New Dialysis patients 2901315536814070460449205252600965416222 % 1-14 years 1111111111 % 15-24 years 4443333223 % 25-34 years 7666666666 % 35-44 years 131211 1210 % 45-54 years 25242625 242524 23 % 55-64 years 27302730282931 32 % >=65 years 23 252425272426 25 Dialysing at 31 st Dec 11842133551507817081193842158423692262722907131637 % 1-14 years 1111111111 % 15-24 years 5555555444 % 25-34 years 11 10 9 999 % 35-44 years 181716 15 14 % 45-54 years 26 % 55-64 years 24 25 26 27 % >=65 years 15161817 181719

14. Source: 21 st MDTR Report 2013, NRR Figure 2.1.4 (b): Age Distribution of New Dialysis Patients 2004-2013 (i) New Dialysis Patients

15. Source: 21 st MDTR Report 2013, NRR (ii) Dialysing patients at 31st December

16. Source: 21 st MDTR Report 2013, NRR Table 2.1.5: Method and Location of Dialysis Patients 2004-2013 Year20042005200620072008200920102011 20122013 New Dialysis patients 2901315536814070460449205252600965416222 % Centre HD 9089 87 8889 8887 % Home and office HD 0101111111 % PD 10 1112 1110 1112 Dialysing at 31 st Dec 12516140101612918105204732323525243279342799933885 % Centre HD 8889 9089 % Home and office HD 1111111111 % PD 1110 9

17. Source: 21 st MDTR Report 2013, NRR Figure 2.1.5: Method and Location of Dialysis Patients 2004-2013 (i) New Dialysis Patients 0 10 20 30 40 50 60 70 80 90 100 Proportion of patients 2004200520062007200820092010201120122013 Year Centre HDHome and office HD CAPD

18. Source: 21 st MDTR Report 2013, NRR 0 10 20 30 40 50 60 70 80 90 100 Proportion of patients 2004200520062007200820092010201120122013 Year Centre HD Home and office HDCAPD ii) Dialysing patients at 31st December

19. Source: 21 st MDTR Report 2013, NRR Table 2.1.6: Funding for Dialysis Treatment 2004-2013 Year20042005200620072008200920102011 20122013 New Dialysis patients 2879314036694049458548845190598464636139 % by Government 5356 57 6059605752 % by Charity 1312111011121112 15 % self funded 29282930 2628262931 % subsidized by Employer 2110110011 % Others 3333112211 Dialysing at 31 st Dec 12516140101612918105204732323525243279342799933885 % by Government 53.455.357.157.458.158.959.359.659.758.2 % by Charity 12.9 11.911.811.511.611.712 12.7 % self funded 30.128.327.427.6 26.826.726.226.427 % subsidized by Employer 11.21.71.61.7 1.41.61.7 % Others 2.62.31.91.61.11.00.90.60.20.4

20. Source: 21 st MDTR Report 2013, NRR Figure 2.1.6: Funding for Dialysis Treatment 2004-2013 (i) New Dialysis Patients

21. Source: 21 st MDTR Report 2013, NRR ii) Dialysing patients at 31st December

22. Source: 21 st MDTR Report 2013, NRR Table 2.1.7: Distribution of Dialysis Patients by Sector 2004-2013 Year 20042005200620072008200920102011 20122013 New Dialysis patients2900315236774069460449185249600265416210 % Government centre333533 323028 2725 % NGO centre3027292625 22 1920 % Private centre3738 41434550 5455 Dialysing at 31 st Dec11842133551507817081193842158423692262722907131637 % Government centre3938 36353432313029 % NGO centre313029 28 27262524 % Private centre30323335373841434547

23. Source: 21 st MDTR Report 2013, NRR Figure 2.1.7: Distribution of Dialysis Patients by Sector 2004-2013 (i) New Dialysis Patients 0 10 20 30 40 50 60 70 80 90 100 Proportion of patients 2004200520062007200820092010201120122013 Year Public centreNGO centrePrivate centre

24. Source: 21 st MDTR Report 2013, NRR (ii) Dialysing patients at 31st December 0 10 20 30 40 50 60 70 80 90 100 Proportion of patients '04'05'06'07'08'09'10'11'12'13 Year Public centreNGO centrePrivate centre

25. Source: 21 st MDTR Report 2013, NRR Table 2.1.8: Primary Renal Diseases 2004-2013 Year20042005200620072008200920102011 20122013 New Dialysis patients 2901315536814070460449205252600965416222 % Unknown cause 2523 2526 27282217 % Diabetes Mellitus 535557 58 575961 % GN/SLE 6755444343 % Polycystic kidney 1111111111 % Obstructive Nephropathy 2222221111 % Toxic Nephropathy 0000000000 % Hypertension 1099999981216 % Others 3331100211

26. Source: 21 st MDTR Report 2013, NRR Figure 2.1.8: Primary Renal Diseases for New Dialysis Patients 2004-2013

27. Source: 21 st MDTR Report 2013, NRR Table 2.2.1: Number and density of Dialysis Centres in Malaysia by State and Sector, Year 2004 to 2013

28. Source: 21 st MDTR Report 2013, NRR Figure 2.2.1(a): Number of Dialysis Centre in Malaysia by Sector, 2004 to 2013 0 100 200 300 400 500 600 700 Number of Dialysis Centre 2004200520062007200820092010201120122013 PublicPrivateNGO

29. Source: 21 st MDTR Report 2013, NRR Figure 2.2.1(b): Number of Dialysis Centre in Malaysia by State and Sector in 2013

30. Source: 21 st MDTR Report 2013, NRR Table 2.2.2: Number and density of HD centres in Malaysia by State and Sector, 2004-2013

31. Source: 21 st MDTR Report 2013, NRR Table 2.2.3: Number and density of PD centres in Malaysia by State and Sector, 2004-2013

32. Source: 21 st MDTR Report 2013, NRR Table 2.2.4: Number and density of HD machines in Malaysia by State and Sector, 2004-2013

33. Source: 21 st MDTR Report 2013, NRR Figure 2.2.4(a): Number of HD machines in Malaysia by Sector from Year 2004 to 2013

34. Source: 21 st MDTR Report 2013, NRR Figure 2.2.4(b): Number of HD machines in Malaysia by State and Sector in Year 2013

35. Table 2.2.5: Number and Prevalence Rate of Dialysis Patients (HD & PD) in Malaysia by State and Sector, 2004-2013 Source: 21 st MDTR Report 2013, NRR

36. Figure 2.2.5(a): Number of Dialysis Patient (HD+PD) in Malaysia by Sector from 2004-2013

37. Source: 21 st MDTR Report 2013, NRR Figure 2.2.5(b): Number of Dialysis Patient (HD+PD) in Malaysia by State and Sector in 2013

38. Source: 21 st MDTR Report 2013, NRR Table 2.2.6: Number and Prevalence Rate of Hemodialysis Patients in Malaysia by State and Sector, 2004-2013

39. Source: 21 st MDTR Report 2013, NRR Table 2.2.7: Number and Prevalence Rate of PD Patients in Malaysia by State and Sector, 2004-2013

40. Source: 21 st MDTR Report 2013, NRR Table 2.2.8: HD Capacity to Patient Ratio among HD Centres in Malaysia by State and Sector, 2004-2013

41. Source: 21 st MDTR Report 2013, NRR Figure 2.2.8(a): HD Capacity to Patient Ratio among HD Centres in Malaysia by State and Sector, 2004-2013

42. Source: 21 st MDTR Report 2013, NRR Figure 2.2.8(b): HD Capacity to Patient Ratio among HD Centres in Malaysia by State and sector, 2013

43. Source: 21 st MDTR Report 2013, NRR Table 2.2.9: Number & density of Certified Dialysis Nurses/ Medical technicians in Malaysia by State and Sector, 2004-2013

44. Source: 21 st MDTR Report 2013, NRR Figure 2.2.9(a): Number of Certified Dialysis Nurses/ Medical technicians in Malaysia by Sector, 2004-2013

45. Source: 21 st MDTR Report 2013, NRR Figure 2.2.9(b): Number of Certified Dialysis Nurses/ Medical technicians in Malaysia by State and Sector, 2013