title: Incidence and renal survival of ESRD in the young Taiwanese population.
abstract: OBJECTIVE
  ESRD in the young represents a heavy burden to patients, families, and health care systems. This nationwide retrospective study characterized the incidence of ESRD and analyzed diagnoses associated with renal survival in the young population in Taiwan.
  
  
  METHODS
  Through use of Taiwan's National Health Insurance Research Database, the population of young patients (age<30 years, including children and young adults) with ESRD between January 1998 and December 2009 were enrolled. The medical claims were used to derive the date when the cause of ESRD was first determined. The medical data were reviewed and the renal survival time (time from first diagnosis of the cause to the start of ESRD) was calculated by experts, including clinical physicians and a large-database specialist.
  
  
  RESULTS
  The incidence rate of ESRD in the young population was high compared with the worldwide rate at 21.1 per million person-years, whereas the incidence in the pediatric group was still similar to that in other countries at 10.3 per million person-years. A total of 2304 patients with new-onset ESRD and identified renal diseases during the study period were enrolled. All preschool-age patients (100%) began receiving peritoneal dialysis as their initial treatment for ESRD. The leading causes, which varied by sex and onset age, were glomerulonephropathy followed by hypertension for the young adult group and glomerulonephropathy followed by congenital anomalies of the kidney and urinary tract (CAKUT) for the pediatric group. Renal survival was cause-dependent. The median overall renal survival duration was 0.8 year (interquartile range [IQR], 0.7-3.5 years). CAKUT-related ESRD had the longest progression time (median renal survival, 16.0 years; IQR, 10.7-23.5 years); glomerulonephropathy progressed more rapidly into ESRD and had the shortest median renal survival of 0.5 year (IQR, 0.1-2.7 years).
  
  
  CONCLUSIONS
  The incidence and causes of ESRD greatly differ between pediatric patients and young adults. Moreover, renal survival in the young population markedly varies depending on the cause of renal disease.
authors.affiliation: Department of Medical Research and Education and , †Department of Pediatrics, National Yang-Ming University Hospital, I-Lan, Taiwan, ‡Department of Medicine and , §Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Tzu-Chun
authors.initials: TC
authors.lastname: Tsai
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Chen
authors.forename: Chiao-Wei
authors.initials: CW
authors.lastname: Lo
authors.forename: Wei-Shu
authors.initials: WS
authors.lastname: Wang
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Lo
authors.forename: Gau-Jun
authors.initials: GJ
authors.lastname: Tang
authors.forename: Peck-Foong
authors.initials: PF
authors.lastname: Thien
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult