Hong Kong Renal Registry 1995–1999

Abstract

This report was based on the data from the Renal Registry of the Hospital Authority of Hong Kong, accounted for 90% to 95% of all the patients on renal replacement therapy (RRT) in Hong Kong. Patients who received RRT under the private sectors were not included in this report. The data were as of 31 March 1999. There were 11 renal units, five satellite centers and four major renal transplant centers. The number of patients on RRT was 4268 [627 patients per million (pmp)], of which 58% (2490 patients, 360 pmp) were on peritoneal dialysis (PD), 13% (576 patients, 85 pmp) on hemodialysis (HD) and 28% (1202 patients, 177 pmp) with functioning kidney transplants (TX). The net increase of the number of patients on RRT from previous year was 10%. The incidence of end-stage renal failure was 762 (112 pmp). The median age of the existing patients on RRT was 52, of which 33% were above the age of 61 years. The median age of the new patients was 56 years, of which 50% were above the age of 61 years. The major causes of renal failure for existing patients were glomerulonephritis 32%, unknown 26% and diabetes 21%. For the new cases, 34% were due to diabetic nephropathy. Of all the patients on RRT, 10% were serologically positive for hepatitis B infection while 6% were positive for hepatitis C infection. Of all the patients on dialysis, 81% were on PD, of which 92% were on continuous ambulatory peritoneal dialysis (CAPD). Of the CAPD patients, 13% were still using “connect” systems, 75% were using “disconnect” systems and 12% using UV flash systems. Nineteen percent of all the patients on dialysis were on HD, of which 54% were on hospital based HD, 21% on satellite center based HD, 9% on charitable center based HD and 3% on home HD. Of the 1202 patients with kidney transplants, 629 (52%) were transplanted in Hong Kong. Of these, 325 (52%) were cadaveric kidney transplantation. For the year ending 31 March 1999, 113 patients (17 pmp) received a kidney transplantation, of which 58 transplants were performed in Hong Kong (30 cadaveric kidneys and 28 living related kidneys). Thirty-one percent of all the patients on RRT were receiving erythropoietin therapy. The annual crude mortality rate for all RRT was 7% (8% for PD, 14% for HD and 1.6% with TX). The major causes of death were cardiovascular (24%), infection (22%) and cerebral vascular accident (6%). The 1 and 5 year patient survivals for kidney transplants performed in Hong Kong between 1 April 1993 to 31 March 1998 were 98%, 96% for living related kidney and 94%, 89% for cadaveric kidney. The 1 and 5 year graft survivals were 92%, 88% (censored), 91%, 85% (not censored) for living related kidney and 89%, 83% (censored), 86%, 79% (not censored) for cadaveric kidney. The overall peritonitis rate for all CAPD systems for the 7 months ending 31 March 1999 was one episode per 21 months. The peritonitis rate of the new disconnect systems was one episode per 20 to 27 months. The point prevalence rate of RRT (1997 data) for Hong Kong was within 15% range of that for Australia, Canada and most European countries, but only 40% to 60% of that for Japan, USA and Taiwan. The percentage of dialysis patients being treated with PD was highest in the world.