robert c atkins bellagio, march 2004
DESCRIPTION
DEVELOPMENT OF STRATEGIES FOR PREVENTION OF CHRONIC KIDNEY DISEASE RELEVENT TO DIFFERENT REGIONS AND COUNTRIES. ROBERT C ATKINS BELLAGIO, MARCH 2004. Eur: 317,000. China: 30,000. USA: 283,000. Japan: 167,000. India: 20.000. Latin Am: 82,000. AUS/NZL: 11,000. World-ESRD (1996). - PowerPoint PPT PresentationTRANSCRIPT
DEVELOPMENT OF STRATEGIES FOR PREVENTION OF CHRONIC KIDNEY DISEASE RELEVENT TO
DIFFERENT REGIONS AND COUNTRIES
ROBERT C ATKINS
BELLAGIO, MARCH 2004
USA: 283,000
Latin Am: 82,000
Eur: 317,000
India: 20.000
China: 30,000
AUS/NZL: 11,000
Japan: 167,000
Schena, Kidney Int (Suppl 74), 2000
World-ESRD (1996)PrevalenceIncidence
1,000,000 220,000
DIALYSIS PATIENTS WORLD-WIDE (1996)
Incidence of Diabetes in E.S.R.FIncidence of Diabetes in E.S.R.FAustralia 1980 - 2000Australia 1980 - 2000
Year of Entry
Number of Diabetics Number of New Patients
0
100
200
300
400
500
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00
0
300
600
900
1200
1500
1800Type 2 (Ins Requiring)Type 2 (Non Insulin)Type 1Total New Patients
Diabetes and hypertension are the main causes for ESRD in the USA
The proportion of ESRD patients with diabetic nephropathy is higher in the USA than in Europe. However, diabetic nephropathy is the most rapidly growing cause of ESRD in European countries
CAUSES OF ESRD IN THE USACAUSES OF ESRD IN THE USA
1990 1992 1994 1996 19980
20
40
60
80
100
120
140 Diabetes
Hypertension
Glomerulonephritis
Cystic kidney
Inci
den
ce r
ates
(x
mil l
ion
po
pu
lat i
on
)
USRDS, 2000
AUSDIAB RESULTS
• 7.2% with diabetes
(3.6% known and 3.6% newly diagnosed)
• 16.1% with impaired glucose metabolism
• 60% overweight or obese
• 61.3% with high cholesterol (7.3% on treatment)
• 29% with high blood pressure (14% on treatment)
PREVALENCE OF RENAL ABNORMALITIES
1. Haematuria>10x106/L 4.6%
2. Proteinuria 2.4%UP:UC>0.2 mg/mg
3. Renal Impairment 11.2%calculated GFR <60 mls/min
No abnormality 82%At least one abnormality 18%Multiple abnormalities 2%
PREVALENCE OF TYPE 2 DIABETES IN ASIA AND PREVALENCE OF TYPE 2 DIABETES IN ASIA AND PACIFICPACIFIC
Age-standardised to Segi’s world population 35-64 years except: * ³40 **30-59 ‡ 30-69 #20-64 § 40-69
0 10 20 30 40
Nauru
Urban PNG - Koki
Aboriginal Australian
Singapore
Urban Western Samoa
Pakistan
India
J apan
Indonesia
Malaysia
White USA
Taiwan
China
PNG Highlands
Prevalence diabetes (%)
#
*
**
§
World
20002025
154 m300 m
55 m72 m
Developed Count. Developing Count.
99 m228 m
16.724.5
39.3
18.2
38.430.7
21.8
9.1
57.2
22.8
37.5
18.6
0.4 0.7
2000
2025
* In million subjects
47%
116%
25%
140%
150%
102%
64%
THE GLOBAL BURDEN OF DIABETES (2000-2025)