CKD Surveillance Using Laboratory Data of the National Preventive Healthcare Service Program For Adults: Experience from Taiwan

To evaluate whether the National Preventive Healthcare Service Program for Adult can be used as a surveillance system to provide information of the magnitude and trends of chronic kidney disease (CKD) in Taiwan.

We used data from Prevention Service Outcome File of the Health Promotion Administration, the official form for registering the clinical data of adults who were aged over 40 year-old and eligible for National Preventive Healthcare Services Program to identify patients with CKD. The definition of CKD is based on decreased kidney function estimated glomerular filtration rate <60 ml/minute per 1·73 m². We estimated age- and sex- adjusted prevalence of CKD from the screened cohort. Combined data of National Health Insurance Research Database of the Health Insurance Administration which includes all beneficiary enrollment data, inpatients and outpatients billing claims and drug prescription, we were able to identify comorbidities, medication status, and the treatment information of these patients.

The screened cohort consisted of over 1,700,000 every year. The unadjusted and adjusted prevalence of CKD stage 3-5 were 20.1% and 12.2% for adults aged over 40 year-old in the year of 2009 and 2012 respectively. Unadjusted prevalences of CKD among those with hypertension, prehypertension and normal blood pressure were 25.8%, 12.8% and 9.4%. Unadjusted prevalences of CKD among diabetes, prediabetes and normal blood sugar were 28.1%, 19.5% and 12.4%. Older patients more likely participated the screening program. CKD prevalence was high among people with prehypertension and prediabetes. Those individual might benefit from interventions aimed at preventing the process of CKD.