title: Epidemiological Study of RRT-Treated ESRD in Nanjing - A Ten-Year Experience in Nearly Three Million Insurance Covered Population.
abstract: BACKGROUND
  The growing burden of end-stage renal disease (ESRD) has been a great challenge to the health care system of China. However, the exact epidemiological data for ESRD in China remain unclear. We aimed to investigate the epidemiology of ESRD treated by renal replacement therapy (RRT) in Nanjing based on analysing ten-year data of Nanjing three million insurance covered population.
  
  
  METHODS
  Using the electronic registry system of Urban Employee Basic Medical Insurance (UEBMI), we included all subjects insured by UEBMI in Nanjing from 2005 to 2014 and identified subjects who developed ESRD and started RRT in this cohort.
  
  
  RESULTS
  The UEBMI population in Nanjing increased from 1,301,882 in 2005 to 2,921,065 in 2014, among which a total of 5,840 subjects developed ESRD and received RRT. Over the 10-year period, the adjusted incidence rates of RRT in the UEBMI cohort gradually decreased from 289.3pmp in 2005 to 218.8pmp in 2014. However, the adjusted prevalence rate increased steadily from 891.7pmp in 2005 to 1,228.6pmp in 2014. The adjusted annual mortality rate decreased from 138.4 per 1000 patient-years in 2005 to 97.8 per 1000 patient-years in 2014. The long-term survival rate fluctuated over the past decade, with the 1-year survival rate ranging from 85.1% to 91.7%, the 3-year survival rate from 69.9% to 78.3% and the 5-year survival rate from 58% to 65.4%.
  
  
  CONCLUSIONS
  Nanjing is facing an increasing burden of ESRD with its improvement of medical reform. The ten-year complete registry data on RRT in urban employees in Nanjing provided a unique opportunity to understand the real threat of ESRD confronting China during its process of health care transition.
authors.affiliation: Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Han
authors.affiliation: Social Insurance Management Center, Nanjing Municipal Human Resources and Social Security Bureau, Nanjing, Jiangsu, China.
authors.forename: Han-Ming
authors.initials: HM
authors.lastname: Huang
authors.affiliation: Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Sun
authors.affiliation: Social Insurance Management Center, Nanjing Municipal Human Resources and Social Security Bureau, Nanjing, Jiangsu, China.
authors.forename: Chao-Ming
authors.initials: CM
authors.lastname: Tan
authors.affiliation: Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Min
authors.initials: M
authors.lastname: Gao
authors.affiliation: Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.affiliation: Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Ri-Ning
authors.initials: RN
authors.lastname: Tang
authors.affiliation: Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Yan-Li
authors.initials: YL
authors.lastname: Wang
authors.affiliation: Southeast University School of Public Health, Nanjing, Jiangsu, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Wang
authors.affiliation: Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Kun-Ling
authors.initials: KL
authors.lastname: Ma
authors.affiliation: Institute of Nephrology, Zhongda Hospital, Southeast University School of Medicine, Nanjing, Jiangsu, China.
authors.forename: Bi-Cheng
authors.initials: BC
authors.lastname: Liu
mesh_terms: D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D019458:Insurance Coverage; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D008297:Male; D015995:Prevalence; D012042:Registries; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000379:methods