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International Journal of Nephrology
Volume 2015, Article ID 184321, 15 pages
Research Article

International Burden of Chronic Kidney Disease and Secondary Hyperparathyroidism: A Systematic Review of the Literature and Available Data

1EpidStat Institute, Ann Arbor, MI 48105, USA
2Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
3School of Medicine, Vanderbilt University, Nashville, TN 37212, USA
4Center for Observational Research, Amgen, Inc., Thousand Oaks, CA 91320, USA
5Department of Nephrology, School of Medicine, University of Michigan, Ann Arbor, MI 48109, USA

Received 10 November 2014; Revised 22 February 2015; Accepted 5 March 2015

Academic Editor: Suresh C. Tiwari

Copyright © 2015 Elizabeth Hedgeman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The international burden of secondary hyperparathyroidism (SHPT) is unknown, but it may be estimable through the available chronic kidney disease and SHPT literature. Structured reviews of biomedical literature and online data systems were performed for selected countries to ascertain recent estimates of the incidence, prevalence, and survival of individuals with CKD and SHPT. International societies of nephrology were contacted to seek additional information regarding available data. Estimates were abstracted from 35 sources reporting estimates of CKD in 25 countries. Population prevalence estimates of CKD stages 3–5 in adults ranged from approximately 1 to 9% (China, Mexico, resp.). Estimates of the population prevalence of maintenance dialysis therapy ranged from 79 per million population (pmp; China) to 2385 pmp (Japan); incidence rates ranged from 91 pmp (United Kingdom) to 349 pmp (United States). Prevalence of SHPT among stage 5D populations was highly variable and dependent upon the disease definition used. Among the few nations reporting, approximately 30–50% of stage 5D patients had serum parathyroid hormone levels >300 pg/mL. Reported incidence and prevalence estimates across the individual nations were variable, likely reflecting differing population demographics, risk factors, etiologies, and availability of treatment through all stages of CKD.