End-stage renal disease in Taiwan: a case-control study.
BACKGROUND
Taiwan has the highest incidence of end-stage renal disease (ESRD) in the world. The epidemiologic features of ESRD, however, have not been investigated. In this case-control study, we evaluated the risk of ESRD associated with a number of putative risk factors.


METHODS
We studied 200 patients among whom ESRD had been newly diagnosed between 1 January 2005 and 31 December 2005; 200 controls were selected from among relatives of patients treated in the general surgery unit. Using a structured questionnaire, we collected information related to socioeconomic factors, history of disease, regular blood or urine screening, lifestyle, environmental exposure, consumption of vitamin supplements, and regular drug use at 5 years before disease onset.


RESULTS
Our primary multivariate risk models indicated that low socioeconomic status was a strong predictor of ESRD (education: odds ratio [OR], 2.78; 95% confidence interval [CI], 1.49-5.19; income: OR, 2.86, 95% CI, 1.48-5.52), even after adjusting for other risk factors. Other significant predictors for ESRD were a history of hypertension (OR, 3.63-3.90), history of diabetes (OR, 3.85-5.50), and regular intake of folk remedies or over-the-counter Chinese herbs (OR, 10.84-12.51). Regular intake of a multivitamin supplement 5 years before diagnosis was associated with a decreased risk of ESRD (OR, 0.12-0.14).


CONCLUSIONS
Our findings indicate that low socioeconomic status, history of hypertension, diabetes, and regular use of folk remedies or over-the-counter Chinese herbs were significant risk factors for ESRD, while regular intake of a multivitamin supplement was associated with a decreased risk of ESRD.
Tsai
Su-Ying
SY
Department of Health Management, I-Shou University, Yanchao Township, Kaohsiung County, Taiwan (R.O.C.). sytsai@isu.edu.tw
Tseng
Hung-Fu
HF
Tan
Hsiu-Fen
HF
Chien
Yu-Shu
YS
Chang
Chia-Chu
CC
D000328:Adult; D016022:Case-Control Studies; D003710:Demography; D019587:Dietary Supplements / Q000706:statistics & numerical data; D004365:Drugs, Chinese Herbal / Q000494:pharmacology; D004781:Environmental Exposure / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
D004365:Drugs, Chinese Herbal