Half a century after the first dialysis procedure was conducted in Taiwan an international symposium was held yesterday to mark the event.
The symposium included a discussion of chronic kidney disease and use of dialysis globally and in Taiwan, which has the highest prevalence of end-stage renal disease (ESRD) anywhere in the world.
Dialysis was first conducted in Taiwan in 1963 at National Taiwan University Hospital.
From a global perspective, “the number of deaths attributable to chronic diseases in general is on the rise,” said Philip Kam-Tao Li, head of nephrology at the Prince of Wales Hospital in Hong Kong.
Despite recent flu scares, global mortality from communicable diseases is forecast to decrease, while deaths from chronic diseases are expected to increase, Li said.
While diabetes is projected to be the seventh leading cause of death by 2030 — down from fourth in 2002 — the two leading causes of death, ischaemic heart disease and cerebrovascular disease (stroke), which ranked first and second respectively in 2002, also frequently afflict patients with diabetes, Li said.
Diabetes can cause various long-term complications, the most common of which is chronic kidney disease.
Chronic kidney disease can eventually lead to ESRD, or kidney failure, that requires patients to undergo dialysis treatment if a kidney transplant is not available.
According to last year’s US Renal Data System Annual Data Report, Taiwan had the highest incidence of ESRD, at 2,584 per million people in 2010, Li said.
According to data collected since 2007, the cost of dialysis procedures accounted for 6.2 percent of the nation’s total healthcare expenditures, while the dialysis prevalence rate was about 0.22 percent, Li said.
As such, healthcare spending on dialysis treatment was 28 times the national average for other treatments.
Statistics made public last week by the Bureau of National Health Insurance indicates that the demand for dialysis treatment continued to rise last year.
Currently, 71,468 patients — or 0.3 percent of the population — are undergoing dialysis treatment, while the cost to the National Health Insurance system is NT$44.329 billion (US$1.48 billion), approximately 7.85 percent of total healthcare costs, the statistics showed.
However, the high number of patients successfully treated for ESRD is testimony to “the improvement in the quality of dialysis care in Taiwan,” National Taiwan University Hospital superintendent Chen Ming-fong (陳明豐) said.
An aging population, a decrease in the mortality rates of diabetes and cardiovascular diseases and an increase in survival rates of patients requiring dialysis are all contributing factors to the high costs, Chen said.
Wang Jung-der (王榮德), chair professor of public health at National Cheng Kung University, said dialysis treatment has been shown to extend the life expectancy of ESRD patients by 10 years, or, 6.5 quality-adjusted life years
However, prevention and control of chronic kidney disease is the fundamental solution, Wang said.
“The early referral of chronic kidney disease patients to nephrologists is strongly advised,” Wang added.