End-stage renal disease in Taiwan: a case-control study

J Epidemiol. 2009;19(4):169-76. doi: 10.2188/jea.je20080099. Epub 2009 Jun 20.


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.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Demography
  • Dietary Supplements / statistics & numerical data
  • Drugs, Chinese Herbal / pharmacology
  • Environmental Exposure / statistics & numerical data
  • Female
  • Humans
  • Kidney Failure, Chronic / drug therapy
  • Kidney Failure, Chronic / epidemiology*
  • Life Style
  • Male
  • Medicine, Traditional
  • Middle Aged
  • Risk Factors
  • Socioeconomic Factors
  • Taiwan / epidemiology
  • Young Adult


  • Drugs, Chinese Herbal