Objectives: determination of morbidity rate of chronic renal failure and causes of disease. Subjective: People with ages of 15 and above. Results: The morbidity rate of the chronic renal failure was 1% (female more frequent than male) in which phase I : 0,27%, phase II: 0,55%; phase III : 0.09%. The chronic pyelitis was the leading cause of the chronic renal failure (63,4%) in which 36, 3% of these accompanied with urinary stone.
Kidney Failure, Chronic ; epidemiology ; diagnosis

Humans ; Kidney Failure, Chronic ; epidemiology ; physiopathology ; therapy ; Singapore ; epidemiology

Chronic kidney disease (CKD) is suffered progressive loss of kidney function lasting more than 3 months and is classified according to the degree of kidney damage (level of proteinuria) and the decreased glomerular filtration rate (GFR). The most severe form of CKD is end-stage renal disease. The prevalence of CKD is high with fast growth rate and the disease burden has become increasingly serious. CKD has become an important public health problem threatening human health. The etiology of CKD is complex. In addition to genetic factors, environmental factors are an important cause of CKD. With the development of industrialization, environmental metal pollution has become increasingly severe, and its impact on human health has received widespread attention. A large number of studies have shown that metals such as lead, cadmium, and arsenic can accumulate in the kidney, which can cause damage to the structure and function of the kidney, and play an important role in the development of CKD. Therefore, summarizing the epidemiological research progress in the relationship between arsenic, cadmium, lead, and other metal exposures and kidney diseases can provide new ideas for the prevention and control of kidney diseases caused by metal exposure.
Humans ; Cadmium/toxicity* ; Arsenic/toxicity* ; Kidney ; Renal Insufficiency, Chronic/epidemiology* ; Kidney Failure, Chronic

OBJECTIVETo study and analysis prevalence and incidence of target organ injury and the relative factors for isolated systolic hypertension (ISH) in Beijing.

METHODS1002 cases aged 80 to 99 years were investigated in 28 cadre retirement centers in Beijing. Blood pressure was taken for three times with mercurial sphygmomanometer in every person, the mean values were recorded and the relative material was gathered according to questionnaire after the health education. Physical examination form of outpatient department and inpatient case history in fixed hospital were analyzed.

RESULTSIn 1002 very old persons, there were 673 hypertensive patients (67.2%) and 455 ISH (45.4%). Among all hypertensive patients, the rate of ISH was 67.6% and double hypertension was 32.4%. Awareness rate was 87.90% and 97.71%, taking antihypertensive drug rate was 77.58% and 80.73%, control rate was 58.68% and 62.84% in ISH and in double hypertension group, respectively, which were no significant differences between the two groups. There was no significant difference in morbidities of cardiac heart disease, myocardial infarction and chronic renal insufficiency between the two groups. The incidences of heart failure, cerebrovascular disease, disability and dementia were 4.62% and 8.72%, 41.54% and 55.50%, 10.55% and 16.06%, 8.57% and 12.84% in ISH and double hypertension group, respectively, which were significant differences between the two groups (P < 0.01). The susceptible age period for ISH was 70 to 79 years in this study.

CONCLUSIONISH is more common in hypertensive patients in very old persons at 28 cadre retirement centers in Beijing. Morbidity of heart failure, cerebrovascular disease, disability and dementia were higher in double hypertension group compared with those in ISH group. The results showed that increase of both systolic and diastolic blood pressure was more dangerous than that of systolic pressure only for very old persons. The improvement of small arterial plastic and the control of blood pressure to target level (< 140/90 mm Hg) in very old hypertensive patients are very important for decreasing the incidence of target organ injury and increasing their life quality and late survival rate.

Aged, 80 and over ; Cardiovascular Diseases ; epidemiology ; Cerebrovascular Disorders ; epidemiology ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; Female ; Humans ; Hyperlipidemias ; epidemiology ; Hypertension ; epidemiology ; physiopathology ; Kidney Failure, Chronic ; epidemiology ; Male ; Prevalence ; Systole

INTRODUCTIONThe aim of this study is to investigate the risk of cancer among end-stage renal disease (ESRD) patients on dialysis in Singapore.

MATERIALS AND METHODSThe study looks at a retrospective cohort of 5505 ESRD patients who had received dialysis between 1998 and 2007. The cancer risk of these patients would be compared against the risk of the general population.

RESULTSDuring a median follow-up time of 3.9 years, 267 (4.9%) dialysis patients developed cancer. The risk of cancer (excluding non-melanoma skin cancer) is 1.66 times higher in dialysis patients than the general population, and is highest at age less than 35 years old and at first year after dialysis. Cancer risk was found to be significantly higher among Chinese dialysis patients, followed by Malays, compared to the general population. The 3 sites with highest elevated cancer risks among dialysis patients compared to the general population are kidney, tongue and multiple myeloma.

CONCLUSIONThe finding of elevated cancer risk among younger dialysis patients is similar to other international studies. High cancer risks among specific cancer sites were also consistent with other studies. In view of the lack of screening procedures for these cancers and shortened expected survival of ESRD patients, cancer screening of ESRD patients should be individualised and based on a reasonable life expectancy and transplant candidacy, keeping in mind the competing risk of cardiovascular mortality.

Comorbidity ; Humans ; Kidney Failure, Chronic ; epidemiology ; therapy ; Neoplasms ; epidemiology ; Renal Dialysis ; Retrospective Studies ; Risk Assessment ; Singapore ; epidemiology

The prevalence of end-stage kidney disease (ESKD) in Singapore remains high and continues to rise. We continue to face major challenges in containing the rising incidence of ESKD and providing sustainable kidney replacement therapy. Our cost projections provide an insight into the present and future, urging a call to action to augment existing initiatives to address the emergent issues.
Female ; Humans ; Incidence ; Kidney Failure, Chronic/therapy* ; Male ; Prevalence ; Renal Replacement Therapy/adverse effects* ; Singapore/epidemiology*

The life expectancy of end-stage renal disease patients undergoing regular hemodialysis (HD) remains significantly lower than in the general population. Reducing excess mortality by improving renal replacement options is an unmet medical need. Online post-dilution hemodiafiltration (HDF) has been promoted as the gold standard, offering improved clinical outcomes, based on numerous observational studies that suggest a reduced mortality risk and lower morbidity with HDF compared with standard HD. However, most randomized controlled trials (RCTs) have failed to demonstrate a significant beneficial effect of HDF on all-cause mortality. The effects on secondary outcomes were often negligible or absent. Unfortunately, these RCTs were characterized by a moderate to high risk of bias. In post-hoc analyses of the largest RCTs and meta-analysis of individual participant data from four RCTs, HDF patients receiving the highest convection volume consistently and dose-dependently saw superior outcomes. However, as these studies were not designed a priori to clarify this issue, and there are no indisputable mechanisms underlying reduced mortality risks, we cannot exclude the possibility that the health status of patients (with vascular access as a proxy) may affect outcomes more than the convective technique itself. There is currently insufficient evidence to support the contention that high-volume HDF confers relevant benefits to patients over standard HD. The conflicting data of published RCTs reduce confidence in the superiority of high-volume convective therapy. Hopefully, ongoing large RCTs (for example, CONVINCE) may supply an indisputable answer to the crucial question of high-volume HDF.
Bias (Epidemiology) ; Convection ; Hemodiafiltration ; Humans ; Kidney Failure, Chronic ; Life Expectancy ; Mortality ; Renal Dialysis

PURPOSE: The aim of this study was to analyze the results of children treated with hemodialysis (HD) at Severance Hospital over 35 years in terms of incidence, etiologies, characteristics, complications, and clinical outcomes. MATERIALS AND METHODS: We analyzed 46 children admitted to Severance Hospital who had undergone HD between January 1979 and December 2013. RESULTS: The main etiologies of the 23 end-stage renal disease (ESRD) patients who had received HD were chronic glomerulonephritis (7 patients, 30.4%) and congenital anomalies of the kidney and urinary tract (7 patients, 30.4%), whereas the etiology of the 23 acute kidney injury (AKI) patients was hemolytic uremic syndrome (6 patients, 26.1%). Compared with ESRD patients, hemocatheter placement in the femoral vein was preferred over the subclavian or internal jugular vein in the AKI patients (p=0.012). The most common complication was catheter related complication (10 patients, 21.7%). The site of hemocatheter insertion was not related to the frequency of oozing. Placing the hemocatheter in the femoral vein resulted in significantly more events of catheter obstruction than insertion in the internal jugular vein or the subclavian vein (p=0.001). Disequilibrium syndrome occurred more frequently in older patients (p=0.004), as well as patients with a greater body weight (p=0.008) and a higher systolic and diastolic blood pressure before HD (systolic: p=0.021; diastolic: p=0.040). CONCLUSION: Based on the 35 years of experience in our center, HD can be sufficiently and safely carried out even in children without significant complications.
Acute Kidney Injury/epidemiology ; Body Weight ; Child ; Child, Preschool ; Chronic Disease ; Female ; Humans ; Infant ; Jugular Veins ; Kidney Failure, Chronic/epidemiology/*therapy ; Male ; Renal Dialysis/*methods ; Treatment Outcome

Since 1981, the Korean Society of Nephrology began annual report on renal replacement therapy in Korea. The annual number of new patients receiving dialysis treatment in 1986 increased to 957 patients (23.3 per million population) from 825 patients (20.4 per million population) in 1985. And the total number of patients on replacement therapy increased from 1,508 patients (37.3 per million population) to 2,534 patients (61.7 per million population). 1,340 patients (32.6 per million population) of these patients were on hemodialysis, 573 patients (13.9 per million population) on continuous ambulatory peritoneal dialysis (CAPD) and 621 patients (15.1 per million population) on functioning renal graft as of December 31, 1986. The common causes of renal failure of new patients were chronic glomerulonephritis (41.6%) followed by diabetic nephropathy (12.6%), nypertensive nephrosclerosis (7.8%), chronic pyelonephritis (2.5%) and others. The annual mortality rate decreased from 21.9% in 1981 to 13.5 in 1986. The common causes of death in patients on dialysis therapy were cardiac (32.8%), vascular (14.7%), infective (14.7%) and social problems (11.2%) in the order of frequency. Recently, the number of patients requiring dialysis is rapidly increasing due to expanded medical insurance support for dialysis and improved economic status of our country. Therefore, it is necessary to draw up counterplan for a rapid growth of the number of new patients.
Hepatitis B/etiology ; Humans ; Kidney Failure, Chronic/epidemiology/*therapy ; *Kidney Transplantation ; *Kidneys, Artificial/adverse effects ; Korea ; Multicenter Studies as Topic

With the rapid aging of the global population posing a serious problem, frailty, a non-specific state that reflects physiological senescence rather than aging in time, has become more widely addressed by researchers in various medical fields. A high prevalence of frailty is found among kidney transplant (KT) candidates and recipients. Therefore, their frailty has become a research hotspot in the field of transplantation. However, current studies mainly focus on the cross-sectional survey of the incidence of frailty among KT candidates and recipients and the relationship between frailty and transplantation. Research on the pathogenesis and intervention is scattered, and relevant review literature is scarce. Exploring the pathogenesis of frailty in KT candidates and recipients and determining effective intervention measures may reduce waiting list mortality and improve the long-term quality of life of KT recipients. Therefore, this review explains the pathogenesis and intervention measures for frailty in KT candidates and recipients to provide a reference for the formulation of effective intervention strategies.
Humans ; Frailty/epidemiology* ; Risk Factors ; Quality of Life ; Kidney Failure, Chronic ; Kidney Transplantation/adverse effects* ; Cross-Sectional Studies ; Transplant Recipients