Forecast of the incidence, prevalence and burden of end-stage renal disease in Nanjing, China to the Year 2025.
There are limited data on the trends of incidence or prevalence of end stage renal disease (ESRD) in China. To assist in future planning for the ESRD program, the trends of incidence, prevalence and health care costs were analyzed and forecasted to the year 2025 by modeling of historical data from 2004 through 2014.



Nanjing urban employee basic medical insurance (NJUEBMI) data were obtained from the Nanjing Medical Insurance Information System from 2004 to 2014. The time series forecasting system in SAS 9.4 was used. Each variable was independently forecasted by the fittest model, which was selected automatically or manually.



The forecasting models demonstrated mean percent errors of -2.49 to 5.62 %, relative to the observed values. The R-square values for the forecasting models ranged from 0.756 to 0.997. On the basis of trends in the historical data, the models projected that the average annual increase in the NJUEBMI population was 4.77 %, with forecasted values of 5,029,270 in 2025 (95 % CI, 4,960,423-5,098,117). The incidence and prevalence of ESRD were projected to increase by 1.19 and 1.95 % annually and were expected to reach 250.5 pmp (95 % CI, 247.7-253.3) and 1505 pmp(95 % CI, 1450-1560) by 2025. Additionally, the costs associated with ESRD were forecasted to increase at a growth rate of 5.80 % for healthcare costs and 7.25‰ for per capita medical expenses, with forecasted values of ¥600.3 million ($92.4 million) (95 % CI, 541.8-658.9) and ¥99.0 thousand ($15.2 thousand) (95 % CI, 98.6-99.3), respectively, by 2025. The incidence and prevalence of kidney transplantation were projected to decrease by 6.58 and 9.79 % annually.



These projections suggest that the incidence, prevalence, healthcare costs, and per capita medical expenses of ESRD would increase in the NJUEBMI population. They provide a basis for discussing the trends of ESRD in China and facing the challenges from the ESRD program.
Department of Nephrology, the Affiliated Xuzhou Hospital of Medical College of Southeast University, No.199, Jiefang South Road, Xuzhou, 221009, Jiangsu, China.
Ling
L
Sun
Department of Information Management, the Affiliated Xuzhou Hospital of Medical College of Southeast University, No.199, Jiefang South Road, Xuzhou, 221009, Jiangsu, China.
Lu-Xi
LX
Zou
Institute of Nephrology, Zhongda Hospital, Southeast University, No. 87, Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, China.
Yu-Chen
YC
Han
Nanjing Municipal Human Resources and Social Security Bureau, Nanjing, China.
Han-Ming
HM
Huang
Nanjing Municipal Human Resources and Social Security Bureau, Nanjing, China.
Zhao-Ming
ZM
Tan
Institute of Nephrology, Zhongda Hospital, Southeast University, No. 87, Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, China.
Min
M
Gao
Institute of Nephrology, Zhongda Hospital, Southeast University, No. 87, Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, China.
Kun-Ling
KL
Ma
Institute of Nephrology, Zhongda Hospital, Southeast University, No. 87, Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, China.
Hong
H
Liu
Institute of Nephrology, Zhongda Hospital, Southeast University, No. 87, Ding Jia Qiao Road, Nanjing, 210009, Jiangsu, China. liubc64@163.com.
Bi-Cheng
BC
Liu
D002681:China / Q000453:epidemiology; D017281:Cost of Illness; D005544:Forecasting; D006264:Health Benefit Plans, Employee / Q000191:economics* / Q000639:trends*; D017048:Health Care Costs / Q000639:trends*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence
End stage renal disease; Forecast; Health care costs; Incidence; Medical insurance; Prevalence