National Prevalence, Regional Distribution, and Risk Factors for CKD in Taiwan

Taiwan has exhibited one of the highest incidence and prevalence rates of dialysis globally, yet updated national data on CKD has been lacking for nearly two decades. We estimated the national CKD prevalence, identified associated risk factors, and evaluated CKD of undetermined etiology (CKDu) in Taiwan. In this cross-sectional study, we analyzed data from 4298 adults age 20 years or older who participated in the 2017-2020 Nutrition and Health Survey in Taiwan, a nationally representative survey employing stratified, three-stage, clustered sampling across 20 administrative divisions. CKD was defined as an eGFR <60 ml/min per 1.73 m 2 or an urine albumin-to-creatinine ratio ≥30 mg/g. Data on demographics, comorbidities, lifestyle factors, and socioeconomic status were collected to identify risk factors associated with CKD. The primary outcome was the national prevalence of CKD. Secondary outcomes included regional CKD prevalence, major risk factors associated with CKD, and characteristics of CKDu. The national CKD prevalence was 10.0%, affecting 1.91 million adults. Prevalence rates for CKD stages 1, 2, 3a, 3b, 4, and 5 were 0.7%, 2.1%, 4.6%, 1.9%, 0.6%, and 0.05%, respectively. CKD prevalence was higher in men (11.9%) than in women (8.1%) and varied regionally, with the highest rate in eastern Taiwan (13.9%), followed by the central (11.5%), southern (11.1%), and northern (8.0%) regions. CKD was independently associated with male sex, older age, diabetes, hypertension, hypertriglyceridemia, gout/hyperuricemia, lower socioeconomic status, and physical inactivity. Only 8% of the patients with CKD were aware of their kidney condition, and CKDu accounted for approximately one-eighth of the CKD population. In conclusion, CKD affects approximately 10% of Taiwanese adults, with marked geographic disparities and low awareness. These findings underscore the need for targeted interventions addressing modifiable risk factors and enhanced screening to improve CKD detection and prevention.