Chronic Kidney Disease(CKD) Surveillance in Taiwan

Background. The high incidence and prevalence of End Stage Renal Disease (ESRD) in Taiwan has steadily increased in past decade. Government has listed Chronic Kidney Disease (CKD) surveillance as an important administrative task since 2005.

Method. To decrease the incidence of ESRD and improve the CKD case management, we established CKD surveillance system.

Results.A CKD surveillance system was established, which encompassed configuration of the registration platform, establishment of the registration standard flow and construction of the registration information quality mechanism. Between 2005 and 2008, a total of 134 medical institutions participated in online registration and more than 36,399 cases completed registration.The proportion of people in CKD stage 1-5 were 2.72%, 7.02%, 33.13%, 26.45%,and 22.98%, respectively. Among them 3422 patients entered ESRD, and 22.12% of patients chose CAPD as dialysis mode, a percentage much higher than PD penetration rate of 7%; 48.63% of the 624 patients on HD already had established A-V shunt, and 83% were arteriovenous fistula; 50.61% of patients initiated HD without use of temporary catheter; 28.76% of HD patients initiated dialysis as outpatients, not through hospitalization; finally, 52.95% of patients had used EPO to treat anemia before initiation of dialysis.

Conclusion. With a good tool to care CKD patient's is very important. By health informatics information technology not only can improve case management quality but also provide the data to health department or government. When our health organizations have a lot of data, we can set up the adequate CKD policy.