國家衛生研究院 NHRI:Item 3990099045/13978
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/13978


    Title: Achievements and challenges in chronic kidney disease care in Taiwan
    Authors: Hsu, CC;Hsu, YH;Wu, MS;Hwang, SJ
    Contributors: Institute of Population Health Sciences
    Abstract: Escalating incidence and prevalence of patients with end-stage kidney disease (ESKD) requiring dialysis in Taiwan has caused a significant societal burden over the last two decades. The society began to know that Taiwan had the highest incidence and prevalence of ESKD all over the world since 2000 when submitting Taiwan data to the United States Renal Data System (USRDS). To reduce this unprecedented challenge, a wealth of continuous efforts has been made by all sectors, including the government, the Taiwan Society of Nephrology (TSN), and the academia. For example, the Health Promotion Administration established the Kidney Health Promotion Institute in 2003 (there were 196 institutes in year 2020) around the island to facilitate the prevention of chronic kidney disease (CKD). The TSN initiated the declaration of the World Kidney Day in 2005, one year ahead of the global initiative launched by the International Society of Nephrology (ISN), to promote public awareness of kidney health and protection. The National Health Insurance (NHI) Administration implemented two pay-for-performance (P4P) programs (pre-ESKD program in 2007 and early CKD program in 2011) to improve the quality of care for patients at various stages of CKD. The National Health Research Institutes (NHRI) hosted two Kidney Health Forums, one in 2011 and the next in 2020, to consolidate a consensus among experts regarding improving CKD prevention and treatment. The reference book “Taiwan Chronic Kidney Disease Clinical Guidelines” was published in 2015, and will be revised in 2022, for bettering quality of CKD/ESKD care in clinical settings. The Executive Yuan implemented a top-down national initiative during 2012–2016 to improve the quality of care for CKD and its prevention. Since 2014, the NHRI and TSN collaborative team jointly published a series of Annual Report on Kidney Disease in Taiwan1 to monitor epidemiological patterns and healthcare conditions for patients with ESKD. Through the endless efforts made by various agencies, Taiwan has earned global prestige for excellent quality of dialysis care evident through many indicators such as low estimated glomerular filtration rate (eGFR = 5.5 ml/min/1.73 m2) in dialysis initiations, cumulative five-year survival (55.6%) for patients undergoing chronic dialysis, and low peritonitis incidence (1.6–2.0 per 100 person-months) for those receiving peritoneal dialysis.1 However, these achievements have not impacted Taiwan's ESKD surge (523 and 3429 per million population for incidence and prevalence, respectively, of treated chronic dialysis in 2018, ranked first in the world).2 Facing this threat, nationwide collaborations should pay more attention to developing innovative strategies for early prevention targeting high-risk people.
    Date: 2022-02
    Relation: Journal of the Formosan Medical Association. 2022 Feb;121(Suppl 1):S3-S4.
    Link to: http://dx.doi.org/10.1016/j.jfma.2021.12.016
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0929-6646&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000760881000002
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85122494958
    Appears in Collections:[Chih-Cheng Hsu] Periodical Articles

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