21st Report of the Malaysian Dialysis and Transplant Registry 2013

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21

TH

_{REPORT OF}

THE MALAYSIAN DIALYSIS &

TRANSPLANT REGISTRY

2013

Sponsors:

Malaysian Society Of Nephrology

Association Of Dialysis Medical Assistants And Nurses

The National Renal Registry Is Funded With Grants From:

The Ministry Of Health Malaysia

Roche

AIN Medicare

Baxter Healthcare

Fresenius Medical Care

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June 2014

© National Renal Registry, Malaysia

ISSN 1675-8862

Published by:

The National Renal Registry

Malaysian Society of Nephrology

Suite 1604, Plaza Permata

6, Jalan Kampar

50400 Kuala Lumpur

Malaysia

Telephone. : (603) 4045 8636

Direct Fax : (603) 4042 7694

e-mail

: [email protected]

Web site : http://www.msn.org.my

Important information:

1. This report is copyrighted. However it may be freely reproduced without the permission of the National Renal

Registry. Acknowledgment would be appreciated. Suggested citation is: BL Goh, LM Ong, YN Lim, (Eds) Twenty

First Report of the Malaysian Dialysis and Transplant 2013, Kuala Lumpur 2014

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ACKNOWLEDGEMENTS

The Malaysian Dialysis and Transplant Registry of the National Renal Registry would

like to thank each and everyone who have in one way or another contributed to

the success of the Malaysian Dialysis and Transplant Registry.

In particular we would like to thank the following:

The Nephrologists, physicians and staff of the Dialysis and

Transplant follow-up centres: thank you for participating in the Registry.

The success of the Registry depends on you.

The Ministry of Health, Malaysia for ﬁnancial support and

other support seen and unseen;

The Clinical Research Centre, in particular Dr Goh Pik Pin and Dr Jamaiyah

for their tireless effort in supporting the work of registries.

For their generous

support:-Roche

AIN Medicare

Baxter Healthcare

Fresenius Medical Care

Lucenxia

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NRR ADVISORY COMMITTEE MEMBERS

2012 to 2014

MEMBERS: MSN APPOINTMENT: FACILITIES

Datuk Dr. Ghazali Ahmad Chairman Hospital Kuala Lumpur

Prof. Dr. Abdul Halim Abdul Gafor University representative University Kebangsaan Malaysia Medical Centre

Dr. S. Prasad Menon Private sector representative Sime Darby Medical Centre Subang Jaya

Dato’ Dr. Ong Loke Meng CRC representative Hospital Penang

Mr. Tam Chong Chiang ADMAN representative Hospital Tengku Ampuan Afzan, Kuantan

Dr. Lim Yam Ngo MDTR sub-committee Chairperson Hospital Kuala Lumpur

Dr. Wong Hin Seng eMOSS sub-committee Chairperson Hospital Selayang

Dr. Rosnawati Yahya MRRB sub-committee Chairperson Hospital Kuala Lumpur

Dr. Goh Bak Leong MDTR Editor Hospital Serdang

Dr. Raﬁdah Abdullah Honorary MSN Treasurer Sultan Haji Ahmad Shah Hospital

STATISTICIAN

Jasmine Chew Sze Ming

NRR MANAGER

Lee Day Guat

CLINICAL RESEARCH ASSOCIATE

Choo Cheh Loo

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ABOUT THE MALAYSIAN DIALYSIS AND

TRANSPLANT REGISTRY (MDTR)……..

The Malaysia Dialysis and Transplant Registry (MDTR) collects information on patients with end stage renal disease (ESRD) on renal replacement therapy (RRT) in Malaysia.

Objectives:

The objectives of the registry are as follows:

1. Describe the natural history of ESRD. The registry shall describe the characteristics of patients with ESRD, its management, and patient survival and quality of life outcomes with treatment; and shall describe variation thereof across different groups, healthcare sectors or geographic regions, and its secular trend over time in Malaysia.

2. Determine effectiveness of treatments for ESRD. The registry shall determine clinical effectiveness and cost effectiveness of treatments of ESRD in real-world clinical practices in Malaysia.

3. Monitor safety and harm of products and services used in the treatment of ESRD. The registry shall serve as an active surveillance system for the occurrence of unexpected or harmful events for products and services.

4. Evaluating access to and quality of treatment services for ESRD. The registry shall assess differences between providers or patient populations based on performance measures that compare treatments provided or outcomes achieved with “gold standards” (e.g., evidence-based guidelines) or comparative benchmarks for speciﬁc health outcomes (e.g., risk-adjusted survival rates). Such programs may be used to identify disparities in access to care, demonstrate opportunities for improvement, establish differentials for payment by third parties, or provide transparency through public reporting.

5. To maintain the national renal transplant waiting list electronically – the eMOSS or electronic Malaysian Organ Sharing System. The dialysis registry shall maintain and updatepatients on dialysis who do not have contraindications to kidney transplantation onto the national renal transplant waiting list according to published agreed criteria. This list is available on the web for ready access by the transplant physicians any time a deceased kidney becomes available.

Registry design:

This is a multi-center, observational cohort study designed to evaluate the health outcomes of patients with ESRD undergoing treatment at participating clinical centres. Patient inclusion criterion is deliberately broad and shall include any patient with a conﬁrmed diagnosis of ESRD.

There is no prescribed study visits. Patient shall attend the clinical site as and when required per the standard of care at the site. Required data shall be collected as they become available.

• A clinical site shall notify all new patients to the registry, and shall continue to do so until the termination of the registry. Patients shall be follow-up for life.

• Participation. Site shall notify the patients’ treatment to the registry in a calendar year of its participation. A site shall similarly notify patients during each year of its participation in the registry.

Registry study population:

The registry study population consists of male or female patients with ESRD to be recruited from participating sites in Malaysia. Participation in this study is voluntary. However, in accordance with the Private Health-care Facilities Act 1998 (AKTA 586), all dialysis health facility are required to submit data to the Malaysian Dialysis and Transplant Registry (MDTR).

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TRANSPLANT REGISTRY (MDTR)……..

TRANSPLANT REGISTRY (MDTR)

TRANSPLANT

GISTRY

ABOUT THE MALAYSIAN DIA

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LYSIS AND

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ABOUT THE MALAYSIAN DIA

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LYSIS AND

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All clinical centres or sites that satisfy the following selection criteria will be invited to participate:

This registry is opened to all clinical sites that provide RRT services for patients with ESRD in Malaysia.

Each site shall have a Principal Investigator who is also a licensed physician / Surgeon and a qualiﬁed professional experienced with ESRD management.

Each site shall appoint a Site Coordinator (SC). The SC is the person at the participating clinical site who is responsible for all aspects of registry management and data collection at site, and who will liaise with the Clinical Registry Manager (CRM) and Clinical Registry Assistant (CRA) at the Registry Coordinating Centre (RCC).

Each site shall accept responsibility for data collection, as well as for ensuring proper record keeping and registry document ﬁling.

Each site shall agree to comply with the registry procedures and shall be willing to be subjected to ongoing review of data by CRM or CRA or other representative of MDTR. This may include one or more site visits by prior arrangement

Patient eligibility criteria:

• All new patients with ESRD undergoing treatment at a participating clinical site are eligible for entry into the registry.

• In addition, a site may opt to enter existing patients on follow-up at the site into the registry.

Registry data:

The data elements to be collected by the registry shall be relevant and reliable with modest burden to sites, shall comply with existing data standard where this exists, shall be compatible with established data set used by other existing registries, and shall employ standard terminology (dictionary) where available.

Two datasets are defined:

• Core dataset: These are data elements that are needed to address the key questions for which the registry was created.

• Non-core dataset: these are speculative data elements included to provide an opportunity to generate hypotheses or to explore other subsidiary questions not of primary interest to the registry.

The data domains and related speciﬁc data elements to be collected by this registry is tabulated below:

A Identiﬁer Name, NRIC number, Other identifying document numbers, Address, Contact numbers

B Demographics Age, Sex, Ethnicity, Educational attainment, Occupation, Household Income group, Weight & Height, Use of tobacco, Funding for Treatment

C Medical history Medical history/ comorbidities, Family history

D ESRD diagnosis Date of ﬁrst diagnosis, Date re-entering each RRT.

E Laboratory investigations Date & time of tests, Blood chemistry, Hematology, Serology

F Treatment Modalities of RRT- haemodialysis, peritoneal dialysis; treatment of other uraemic complications; kidney transplantation

G Outcomes Patient survival; death, date of death, cause of death Quality of Life/ Work rehabilitation status

H Economics Source of funding for dialysis treatment, and immunosuppressive drug treatment for transplantation

J Healthcare provider

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Note: *=Ceased 2013, CC# =Award of Compliance Certificate, AR=annual treatment return vii

PARTICPATING HAEMODIALYSIS CENTRES 2013

Haemodialysis Centre CC# AR Haemodialysis Centre CC# AR

<80% 801 Rumah Sakit Angkatan Tentera (Kuching)

94 Hospital Angkatan Tentera (Terendak) 96 Hospital Angkatan Tentera (Lumut) Afiat Dialysis Centre

Aiman Dialysis Centre Al-Islam Specialist Hospital Alkom Bakti Dialysis Alor Gajah Dialysis Centre Alor Gajah Hospital Alor Setar Dialysis Centre AMD Rotary (Penang) Ampang Hospital Anggun Dialysis Centre

Apex Club of Klang-NKF Charity Dialysis Centre Asia Renal Care (Sg Petani)

Assunta Hospital Bakti-NKF Dialysis Centre Balik Pulau Hospital Baling Hospital Bangi Dialysis Centre Banting Hospital Batu Gajah Hospital Batu Pahat Rotary Bau Hospital

BBA (Butterworth) Dialysis Centre BBA (Kota Kinabalu) Dialysis Centre BBA (Puchong) Dialysis Centre BBA (Tawau) Dialysis Centre Beaufort Hospital

Beluran Hospital Bentong Hospital Bertam Dialysis Centre Besut Hospital Betong Hospital Bintulu Hospital Bintulu Specialist Hospital BP Renal Care (Batu Pahat) BP Renal Care (Kluang) BP Renal Care (Rengit) BP Renal Care (Segamat) BP Renal Care Simpang Renggam BP Renalcare (Yong Peng)

Buddhist Tzu Chi Dialysis Centre (Butterworth) Buddhist Tzu Chi Dialysis Centre (Kedah) Buddhist Tzu Chi HD Centre (Penang) Bukit Mertajam Hospital

C.S. Loo Kidney & Medical Specialist Centre Caring Dialysis Centre (Teluk Intan)* Caring Dialysis(Sandakan)

Carlatan Dialysis Centre (Bukit Mertajam) Carlatan Dialysis Centre (Sungai Petani) Changkat Melintang Hospital

Charis-NKF Dialysis Centre Che Eng Khor Centre Cheras Dialysis Centre CHKMUS-MAA Medicare Charity Dalat Hospital

Damai Medical & Heart Clinic Damansara Specialist Hospital Davita Seri Setia Dialysis Centre DEMC Dialysis Centre D'kasih Hemodialisis DSS Dialysis Centre (Rawang) Duchess of Kent Hospital Dungun Hospital Eagles Dialysis Centre EAM Dialysis Centre Fatimah Hospital Fitra Med

Fo Yi NKF Dialysis Centre (1) Fo Yi NKF Dialysis Centre (2) Gerik Hospital

Giat Kurnia Dialysis Centre (Nilai) Gleneagles Medical Centre Golden Age Dialysis Centre Gua Musang Hospital

Haemodialysis Association Klang Haemodialysis Bestari Kampar Happy Kid Nees Dialysis Centre Harmoni Dialysis (Damansara) Harmoni Dialysis (Sg Long) Harmony Sofia Dialysis Centre Healthcare Dialysis Centre

Hemodialisis Yayasan Veteran ATM (S Kembangan) Hope Haemodialysis Society Ipoh

Hospital Angkatan Tentera Tuanku Mizan Hospital Daerah Daro

Hospital Enche' Besar Hajjah Khalsom Hospital Pakar Sultanah Fatimah (Muar) Hospital Queen Elizabeth II

Hospital Sultanah Hajjah Kalsom Hospital Sultanah Nora Ismail Hudaz Dialysis Centre Hudaz Tunjong Dialysis Centre Hulu Terengganu Hospital Ibnu Al-Nafis Dialysis Centre Iman Dialysis

Imercy Dialysis Centre Island Hospital Jasin Hospital

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Note: *=Ceased 2013, CC# =Award of Compliance Certificate, AR=annual treatment return

PARTICPATING HAEMODIALYSIS CENTRES 2013

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>=80% JB Lions MAA-Medicare Charity Dialysis Centre (2) Jelebu Hospital

Jeli Hospital Jempol Hospital Jengka Hospital Jerantut Hospital Jerteh Dialysis Centre JJ Lions Dialysis Centre

Johor Quarries Association Dialysis Centre Johor Specialist Hospital

Kaizenbros Dialysis Centre Kajang Hospital

Kampar Hospital Kanowit Hospital Kapit Hospital KAS-Rotary-NKF Kay Tee Dialisis

Kelana Jaya Medical Centre* Keluarga Bahagia Haemodialisis Kemaman Hospital

Keningau Hospital Kepala Batas Hospital Klinik Waqaf An-Nur (Ijok) Kota Belud Hospital Kota Kinabatangan Hospital Kota Marudu Hospital Kota Tinggi Hospital

KPJ Ampang Puteri Specialist Hospital KPJ Kajang Specialist Hospital KPJ Klang Specialist Hospital KPJ Kluang Utama Specialist Hospital KPJ Penang Specialist Hospital KPJ Puteri Specialist Hospital KPJ Sabah Specialist Hospital KPJ Selangor Specialist Hospital Kuala Kangsar Hospital Kuala Krai Hospital Kuala Kubu Bharu Hospital Kuala Lipis Hospital

Kuala Lumpur Hospital (Paed.) Kuala Lumpur Hospital Kuala Lumpur Lions Renal Centre Kuala Nerang Hospital

Kuantan Clinical Diagnostic Centre Kuantan Dialysis Centre

Kuantan Medical Centres Kuantan Specialist Centre Kuching Specialist Hospital Kudat Hospital

Kulim Haemodialysis (CS Tan) Kulim Hospital

Labuan Hospital

Lahad Datu Hospital Lam Wah Ee Hospital Langkawi Hospital Lawas Hospital Likas Hospital (Paed) Likas Hospital

Lim Boon Sho Dialysis Centre Limbang Hospital

Lions Club Kota Budaya Dialysis Centre Lipis Dialysis Centre

Loh Guan Lye Specialist Centre Lundu Hospital

MAA Charity Dialysis (Kota Bharu) MAA-Medicare Charity (Butterworth) MAA-Medicare Charity (Kuala Lumpur) MAA-Medicare Charity (Mentakab) MAA-Medicare Charity (Sg Besi) MAA-Medicare Charity (Teluk Intan) MAA-Medicare Kidney (Kajang) Machang Hospital

Mahkota Medical Centre MAIS Dialysis (Melawati) Marudi Hospital

MB Star Rawatan Dialisis (Hutan Melintang) MB Star Rawatan Dialisis (Kelana Jaya) MB Star Rawatan Dialisis

Melaka Hospital

Mentakab Haemodialysis Unit Mersing Hospital

Mersing Rotary Centre Metro Specialist Hospital Miri Hospital

Miri Red Crescent Dialysis Centre Muadzam Shah Hospital Muar Dialysis

Muar Lions Renal Centre Muhibah Renal Care Mukah Hospital

Mynephro Dialysis Sdn Bhd Mysha Qasih Dialysis Centre Nefrol I-Care

NEPH Dialysis Centre Sdn Bhd Neph Sdn Bhd (Sg Ara) Nephcare Dialysis Centre Nephrolife Dialysis Centre Nobel Dialysis Centre Tuaran Nobel Dialysis Centre

Normah Medical Specialist Centre Northern Dialysis Centre Nucare Dialysis Centre Nur Dialysis Centre Nur Iman Dialysis Pahang

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PARTICPATING HAEMODIALYSIS CENTRES 2013

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>=80% Pahang Buddhist Association

Pakar Perdana Hospital Pantai Air Keroh Hospital Pantai ARC Dialysis Services Pantai Hospital Ampang Pantai Hospital Penang Pantai Hospital Sungai Petani Papar Hospital

Parit Buntar Hospital Pasir Mas Hospital Pekan Hospital

Pelangi Haemodialysis Centre

Pemodalan Negeri Selangor Dialisis Centre Penang Adventist Hospital

Penang Caring Dialysis Society Persada Dialysis Centre

Persatuan Amal Chin Malaysia Barat Persatuan Buah Pinggang Sabah Persatuan Dialisis Cahaya Kuching Persatuan Dialisis Kurnia PJ

Persatuan Hemodialysis Kinabalu Sabah Persatuan Kebajikan Haemodialysis St Anne BM Persatuan Membaiki Akhlak-Che Luan Khor_NKF Pertubuhan Bakti Fo En Bandar Kulim

Pertubuhan Dialisis Rotary-Satu Hati

Pertubuhan Hemodialisis Muhibbah Segamat (Labis) Pertubuhan Hemodialisis Muhibbah

Pertubuhan Hemodialisis SPS Pertubuhan Kebajikan Amitabha

Pertubuhan Kebajikan Hemodialisis Hospital Pakar Putra Melaka Pertubuhan Perkhidmatan Haemodialisis Ar-Ridzuan Pertubuhan Perkhidmatan Hemodialisis AIXIN Kerian Peter Mole MAA-Medicare Charity Dialysis Centre Ping Rong-NKF

PJCC Dialysis Centre

PMA Chan Meng Khor-MAA Medicare Charity Dialysis Centre Pontian Hospital

Pontian Rotary Haemodialysis Centre Port Dickson Hospital

Premier Renal Care Prima Dialisis Lagenda Putra Prima Dialysis Kluang Prima Dialysis Masai Prince Court Medical Centre Province Wellesley Renal Medifund Pulau Pangkor Hospital

Pulau Pinang Hospital (Paed) Pulau Pinang Hospital

Pusat Dialisis & Kesihatan Masjid Bandar Baru Uda Pusat Dialisis Aiman (Shah Alam)

Pusat Dialisis Airah Pusat Dialisis Albukhary

Pusat Dialisis An'nur Seksyen 13 Pusat Dialisis An'nur

Pusat Dialisis Bandar Sri Permaisuri Pusat Dialisis BMC

Pusat Dialisis Cahaya

Pusat Dialisis CAT Negeri Pulau Pinang Pusat Dialisis Darul Iltizam (Slim River) Pusat Dialisis Darul Iltizam (Taiping) Pusat Dialisis Ehsan Perak (Bagan Serai) Pusat Dialisis Ehsan Perak (Parit Buntar) Pusat Dialisis Ehsan Perak (Perda) Pusat Dialisis Giat Kurnia (Masjid Tanah) Pusat Dialisis Giat Kurnia (Merlimau) Pusat Dialisis Intan

Pusat Dialisis Jasmine Pusat Dialisis Kuala Kangsar Pusat Dialisis LZS (Kapar) Pusat Dialisis LZS (Sg. Besar) Pusat Dialisis MAIDAM Pusat Dialisis MAIS (Shah Alam) Pusat Dialisis MAIS

Pusat Dialisis Makmur (Batu Gajah) Pusat Dialisis Marjina

Pusat Dialisis Mesra (Kuala Selangor) Pusat Dialisis MS*

Pusat Dialisis Mukmin Gurun Pusat Dialisis Mukmin Ipoh Pusat Dialisis Mukmin Sikamat Pusat Dialisis Mukmin Simpang Ampat Pusat Dialisis Mukmin Telok Panglima Garang Pusat Dialisis Mukmin Temerloh

Pusat Dialisis Murni

Pusat Dialisis Mutiara (Ayer Tawar) Pusat Dialisis Mutiara

Pusat Dialisis Myangkasa

Pusat Dialisis Nefro Utama (Bangsar) Pusat Dialisis Nefro Utama (Johor Bahru) Pusat Dialisis Nefro Utama (Kota Tinggi) Pusat Dialisis Nefro Utama (Seberang Perai) Pusat Dialisis Nefro Utama Pontian Pusat Dialisis Nephrocare (Bukit Piatu) Pusat Dialisis Nephrocare (Klang)

Pusat Dialisis NKF - Dato' Dr GA Sreenevasan Pusat Dialisis NKF-Kelab Lions Alor Star Pusat Dialisis NKF-Rotary Damansara Pusat Dialisis NKF-Sandakan Kidney Society Pusat Dialisis NKF-Sang Riang (Triang)

Pusat Dialisis NKF-Yayasan Buah Pinggang Kemaman Pusat Dialisis NKF-Yayasan Dialisis Pertubuhan Pendidikan Akhlak Taiping Pusat Dialisis NKF-Yayasan Sultanah Bahiyah Pusat Dialisis Nuraeen

Pusat Dialisis Pakar Medi-Nefron (Lestari)

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PARTICPATING HAEMODIALYSIS CENTRES 2013

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>=80% Pusat Dialisis Pakar Medi-Nefron (Putra Permai)

Pusat Dialisis Palomar Pusat Dialisis Penawar Permai

Pusat Dialisis Perbadanan Islam (Johor Bahru) Pusat Dialisis Perbadanan Islam (Mersing) Pusat Dialisis Perbadanan Islam (Pontian) Pusat Dialisis Persatuan Pesakit Buah Pinggang Trengganu Pusat Dialisis Prima

Pusat Dialisis Putra Jaya (Banting) Pusat Dialisis Rakyat Ampang Pusat Dialisis Rakyat Lembah Keramat Pusat Dialisis Rakyat Sementa Pusat Dialisis Rakyat Taman Medan Pusat Dialisis Renal Pure Pusat Dialisis Setia (Ipoh) Pusat Dialisis Sijangkang Pusat Dialisis Simpang Renggam Pusat Dialisis SJ (Sg Bakap) Pusat Dialisis Subang

Pusat Dialisis Taiping (Kamunting) Pusat Dialisis Taiping (Kuala Kangsar) Pusat Dialisis Taiping (Parit Buntar) Pusat Dialisis Taiping

Pusat Dialisis Terengganu/NKF Pusat Dialisis Tg Malim Pusat Dialisis Touch

Pusat Dialisis Veteran ATM (Senawang) Pusat Dialisis Veteran ATM (Seri Rampai) Pusat Dialisis Waqaf An-nur (Batu Pahat) Pusat Dialisis Waqaf An-nur (Pasir Gudang) Pusat Dialisis Waqaf An-Nur (Sarawak)

Pusat Dialisis Yayasan Buah Pinggang Kebangsaan (Kota Bharu) Pusat Dialisis Zara

Pusat Dialyisis Ibnu Sina (Kuala Ketil) Pusat Dialysis Comfort

Pusat Dialysis Ibnu Sina (Bagan Serai) Pusat Dialysis Ibnu Sina (Cawangan Rawang) Pusat Dialysis Ikhlas

Pusat Dialysis Makmur (Senai) Pusat Dialysis Mesra (Kapar) Pusat Dialysis Mesra (Rahman Putra) Pusat Dialysis Remedic

Pusat Dialysis Setia

Pusat Dialysis Tuanku Syed Putra_NKF Pusat Haemodialisis Bayu Caw. Taman Tasik Pusat Haemodialisis Bayu Rembau Pusat Haemodialisis Dr. Ismail Pusat Haemodialisis Renalife Pusat Haemodialisis Suria (Tangkak) Pusat Haemodialisis Zakat (Bayan Lepas) Pusat Haemodialisis Zakat (Jawi) Pusat Haemodialisis Zakat Kedah

Pusat Haemodialisis Zakat Tasek Gelugor Pusat Haemodialysis Amal Lexin

Pusat Haemodialysis Majlis Agama Islam Negeri Johor Pusat Haemodialysis Nilam (Seri Kembangan) Pusat Haemodialysis Prihatin Tengku Besar Trengganu Pusat Haemodialysis Suria (Senawang)

Pusat Haemoialisis Suria (Tampin) Pusat HD SJAM Bacang Melaka Pusat Hemodialisis Al Husna Pusat Hemodialisis Ar-Raudhah Pusat Hemodialisis Bandar Mas Pusat Hemodialisis Bayan Baru Pusat Hemodialisis Bayu Pusat Hemodialisis Beng Siew

Pusat Hemodialisis Berkat Seroja (Kuala Pilah) Pusat Hemodialisis Berkat Seroja (Machang) Pusat Hemodialisis Darul Iltizam (Ipoh) Pusat Hemodialisis Darul Iltizam (Tapah) Pusat Hemodialisis Darul Takzim (Batu Pahat) Pusat Hemodialisis Darul Takzim (Parit Raja) Pusat Hemodialisis Dato' Lee Kok Chee Pusat Hemodialisis Desa Aman Puri Pusat Hemodialisis Dr Azhar Jitra Pusat Hemodialisis Dr Azhar Pusat Hemodialisis Fasa (Kg Medan) Pusat Hemodialisis Fasa (Sri Manja) Pusat Hemodialisis Felda

Pusat Hemodialisis Gemencheh Pusat Hemodialisis Harmoni (Cheras) Pusat Hemodialisis Harmoni (Shamelin) Pusat Hemodialisis Hidayah

Pusat Hemodialisis Impian Kluang Pusat Hemodialisis Impian Pusat Hemodialisis Islam Makmur Pusat Hemodialisis Jerantut

Pusat Hemodialisis Kampar Yayasan Nanyang-SJAM Pusat Hemodialisis Kau Ong Yah Ampang

Pusat Hemodialisis KOPPES Pusat Hemodialisis Krisda Pusat Hemodialisis MAIJ

Pusat Hemodialisis MAIWP-PICOMS (Jln Pahang) Pusat Hemodialisis MAIWP-PICOMS

Pusat Hemodialisis Manjung

Pusat Hemodialisis Mawar (Kuala Pilah) Pusat Hemodialisis Mawar (Mantin)

Pusat Hemodialisis Mawar (Yong Peng) HD Unit Pusat Hemodialisis Mawar Gemas

Pusat Hemodialisis Mawar Kuching

Pusat Hemodialisis Mawar N. Sembilan (Bahau) Pusat Hemodialisis Mawar N. Sembilan (Lukut) Pusat Hemodialisis Mawar N. Sembilan (Rantau) Pusat Hemodialisis Mawar N. Sembilan (Sepang)

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PARTICPATING HAEMODIALYSIS CENTRES 2013

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>=80% Pusat Hemodialisis Mawar N. Sembilan (Seputih)

Pusat Hemodialisis Mawar N. Sembilan (Seremban) Pusat Hemodialisis Mawar N. Sembilan (Seri Kembangan) Pusat Hemodialisis Mergong

Pusat Hemodialisis Muar Pusat Hemodialisis Nabilah Pusat Hemodialisis Nilam (Semenyih) Pusat Hemodialisis Nour

Pusat Hemodialisis Perkis Pusat Hemodialisis Permata Pusat Hemodialisis PMKL Pusat Hemodialisis PUSRAWI Pusat Hemodialisis Qaseh

Pusat Hemodialisis Rotary Kota Tinggi Pusat Hemodialisis Rotary Kulai Pusat Hemodialisis S P

Pusat Hemodialisis Sejahtera (Batu Pahat) Pusat Hemodialisis Sejahtera Muar Pusat Hemodialisis Seroja (Baling) Pusat Hemodialisis Seroja (Kulim 1) Pusat Hemodialisis Seroja (Kulim 2) Pusat Hemodialisis Shah Alam Pusat Hemodialisis Sinona

Pusat Hemodialisis SJAM Pulau Sebang Pusat Hemodialisis Syifa (Batangkali) Pusat Hemodialisis Syifa (Bukit Gambir) Pusat Hemodialisis Syifa (Pendang) Pusat Hemodialisis Waz Lian

Pusat Hemodialisis Yayasan Toh Puan Zurina Pusat Hemodialisis Zakat (Balik Pulau) Pusat Hemodialisis Zakat (Bukit Mertajam) Pusat Hemodialisis Zakat (Butterworth) Pusat Hemodialisis Zakat (Kepala Batas) Pusat Hemodialisis Zakat (P. Pinang) Pusat Hemodialsis Mutiara Pusat Hemodialysis Bestari Pusat Hemodialysis Medipro Alliance Pusat Hemodialysis Suria (Bentong) Pusat Hemodialysis Suria (Melaka) Pusat Hemodialysis Suria Kuantan

Pusat Hemodialysis Yayasan Veteran ATM (Batu Caves) Pusat Jantung Hospital Umum Sarawak

Pusat Kelestarian Dialysis Pusat Kesihatan Jitra

Pusat Kesihatan Universiti (UTHO) Pusat Pakar Dialisis Traktif (Besut) Pusat Pakar Dialisis Traktif (Jitra) Pusat Pakar Dialisis Traktif (Kuala Pilah) Pusat Pakar Dialisis Traktif (Seremban) Pusat Pakar Dialysis Traktif

Pusat Pakar Tawakal

Pusat Perbadanan Islam (Segamat)

Pusat Perkhidmatan Haemodialisis USIM Pusat Perubatan Dialisis (Bangi) Pusat Perubatan Dialisis Dengkil Pusat Perubatan Dialisis Semenyih Pusat Perubatan Primier HUKM

Pusat Perubatan Universiti Kebangsaan Malaysia Pusat Rawatan Dialisis Ahmad Khalif

Pusat Rawatan Dialisis Farah Mahami Pusat Rawatan Dialisis Fazwinna Pusat Rawatan Dialisis Fitra (Kuantan) Pusat Rawatan Dialisis Fitra (Maran)

Pusat Rawatan Dialisis Fungates Superflow-NKF Pusat Rawatan Dialisis Good Health-NKF (Kg Pandan) Pusat Rawatan Dialisis Hidayah (Sepang)

Pusat Rawatan Dialisis Hidayah Pusat Rawatan Dialisis Islah (Batu Caves) Pusat Rawatan Dialisis Islah (KL) Pusat Rawatan Dialisis Islah (Kota Bharu) Pusat Rawatan Dialisis Islah (Kuala Terengganu) Pusat Rawatan Dialisis Islah (Prima Sri Gombak) Pusat Rawatan Dialisis Islah (Selayang) Pusat Rawatan Dialisis Lions-NKF (Penang) Pusat Rawatan Dialisis MUIS-NKF Pusat Rawatan Dialisis Mukmin

Pusat Rawatan Dialisis Nefro Utama (Masjid Tanah) Pusat Rawatan Dialisis Nefro Utama (Puchong) Pusat Rawatan Dialisis Nefro Utama (Setapak) Pusat Rawatan Dialisis Tun Abdul Razak-NKF Kuantan Pusat Rawatan Dialysis Nefro Utama (Kajang Prima) Pusat Rawatan Fitra (Muadzam)

Pusat Rawatan Haemodialisis Wan Nong Pusat Rawatan Hemodialisis Felina

Pusat Rawatan Hemodialisis Sang Riang Bera* Pusat Rawatan Hemodialisis Tunku Sarina Pusat Rawatan Perbadanan Islam (Kota Tinggi) Pusat Waqaf An-nur (Senawang)

Putera Bistari Dialysis Centre Putra Haemodialysis Centre Putra Medical Centre Putrajaya Hospital

Putri Haemodialysis Centre (Ipoh) PWRM (BM) Dialysis Centre Quality Dialysis (Batang Berjuntai) Quality Dialysis Care (Bangi) Quality Dialysis Care (Cheras) Quality Dialysis Care (Gurun) Quality Dialysis Care (Jerantut) Quality Dialysis Care (Kangar) Quality Dialysis Care (Kota Kinabalu) Quality Dialysis Care (Meru) Quality Dialysis Care (Pendang) Quality Dialysis Care (Sabak Bernam)

(13)

Haemodialysis Centre CC# AR

PARTICPATING HAEMODIALYSIS CENTRES 2013

_(con’t)

xii

Haemodialysis Centre CC# AR

>=80% Quality Dialysis Care (Sg Besar)

Quality Dialysis Care (Sg. Petani Selatan) Quality Dialysis Care (Sg. Petani Utara) Quality Dialysis Care (Sg. Siput) Quality Dialysis Care (Tanjung Karang) Quality Dialysis Care (Wangsa Maju) Queen Elizabeth Hospital

Raja Perempuan Zainab II Hospital Raja Permaisuri Bainun Hospital Ranau Hospital

Raub Dialysis Centre Raub Hospital

Rawatan Dialisis Bukit Tinggi Rejang Medical Centre Renal Associates

Renal Care (Ipoh Specialist) Renal Care (Kedah) Renal Care Dialysis Services Renal Dialysis Centre Renal Life Dialysis Centre Renal Link (Penang) Renal Therapy Services Renal-Link (Kelantan)

S.P. Menon Dialysis Centre (Klang) S.P. Menon Dialysis Centre (Kuala Lumpur) S.P. Menon Dialysis Centre (Petaling Jaya) Saratok Hospital

Sarawak General Hospital Sarikei Hospital Sayang Dialysis Selayang Seberang Jaya Hospital Seberang Perai (Bagan) Segamat Hospital Selama Hospital Selayang Hospital (Paed) Selayang Hospital Semporna Hospital Sentosa Medical Centre Serdang Hospital

Seremban Specialist Hospital Seri Benut Dialysis Seri Manjung Hospital Serian Hospital Setiu Hospital Sg Siput Hospital Sibu Hospital Sibu Kidney Foundation Sik Hospital

Sime Darby Medical Centre Parkcity Sime Darby Medical Centre Subang Jaya Simunjan Hospital

Sinar Haemodialysis (Batu Pahat)

Sinar Haemodialysis (Parit Raja) Sinar Hemodialisis

Sipitang Hospital SJ Dialysis Centre (Bidor) SJ Dialysis Centre (Ipoh) SJ Dialysis Centre (Seberang Jaya)

SJAM_KPS Pusat Hemodialisis Centre 10 (Bintulu) SJAM_KPS Pusat Hemodialisis Centre 15 (Ipoh) SJAM-KPS Haemodialysis Centre 1 (Raja Muda Musa) SJAM-KPS Haemodialysis Centre 11 (Shah Alam) SJAM-KPS Haemodialysis Centre 12 (Balakong) SJAM-KPS Haemodialysis Centre 2 (Klang) SJAM-KPS Haemodialysis Centre 3 (Banting) SJAM-KPS Haemodialysis Centre 5 (Rawang) SJAM-KPS Haemodialysis Centre 6 (Kuala Selangor) SJAM-KPS Haemodialysis Centre 8 (Sibu) SJAM-KPS Haemodialysis Centre 9 (Raub) SJAM-KPS Pusat Hemodialisis Tasik Puteri Slim River Hospital (Tanjong Malim) Smartcare Dialysis Centre (Subang Jaya) Smartcare Dialysis Clinic (Cheras) Sri Aman Hospital

Sri Kota Medical Centre Subang Dialysis Centre Sultan Abdul Halim Hospital Sultan Haji Ahmad Shah Hospital Sultan Ismail Hospital (Paed) Sultan Ismail Hospital Sultanah Aminah Hospital Sultanah Bahiyah Hospital Sultanah Nur Zahirah Hospital Sungai Bakap Hospital Sungai Buloh Hospital Sunway Medical Centre (2) Sunway Medical Centre

Superkids Trinity-NKF Dialysis Centre Suria Dialysis Centre (Temerloh) Suriya Dialysis Centre Systemic Dialysis Centre (2) Systemic Dialysis Centre Syukur Dialisis (Petaling Jaya) Syukur Dialisis (Puchong) Syukur Dialisis (Shah Alam) Taiping Hospital

Taiping Medical Centre Tambunan Hospital Tampin Hospital

Tan Sri Muhyiddin Charity Dialysis Centre Tanah Merah Hospital

Tangkak Hospital Tangkak Lions Renal Centre Tanjung Karang Hospital

(14)

PARTICPATING HAEMODIALYSIS CENTRES 2013

_(con’t)

xiii

>=80% Tapah Hospital

Tawau Hospital Teluk Intan Hospital

Temenggong Seri Maharaja Tun Ibrahim Hospital Tenang Haemodialysis Centre

Tenang Haemodialysis Jasin Tengku Ampuan Afzan Hospital (Paed) Tengku Ampuan Afzan Hospital Tengku Ampuan Jemaah Hospital Tengku Ampuan Rahimah Hospital Tengku Anis Hospital

Tenom Hospital

The Kidney Dialysis Centre (1) The Kidney Dialysis Centre (2) The Nayang-NKF Dialysis Centre The Penang Community HD Society The Rotary HD Centre (Johor Bahru) Timberland Medical Centre Total Kidney Care Haemodialysis TSC Renal Care

Tuanku Ampuan Najihah Hospital Tuanku Fauziah Hospital Tuanku Ja'afar Hospital (Paed) Tuanku Ja'afar Hospital

Tuaran Hospital Tulips Dialysis Centre Tumpat Hospital

Tung Shin Hospital & Yayasan Nanyang Press Tung Shin Hospital

Unit Hemodialisis Komuntiti Kodiang Universiti Kebangsaan Malaysia Bangi Universiti Sains Malaysia Hospital University Malaya Medical Centre University Malaya Specialist Centre Woh Peng Cheang Seah

Yakin Jaya Haemodialysis Yan Hospital

Yayasan Dialysis Pendidikan Akhlak Perak-NKF Ipoh Yayasan Kebajikan SSL Puchong

Yayasan Kebajikan SSL

Yayasan Pembangunan Keluarga Johor-NKF Yayasan Rotary Kluang

YKN Dialisis (Kuala Lumpur)* YKN Dialisis Kota Bharu YKN Dialisis Kuala Pilah YKN Dialisis Rompin Zhi En Dialysis Centre

Yes

PARTICIPATING PD CENTRES 2013

Peritoneal dialysis centre CC# AR Peritoneal dialysis centre CC# AR

<80% 96 Hospital Angkatan Tentera (Lumut)

Besut Hospital

BP Renal Care (Batu Pahat)* Duchess of Kent Hospital

Hospital Pakar Sultanah Fatimah (Muar) Kemaman Hospital

Kuala Lumpur Hospital (Paed.) Kuala Lumpur Hospital Likas Hospital (Paed) Melaka Hospital

Normah Medical Specialist Centre Pantai Hospital Batu Pahat Prince Court Medical Centre Pulau Pinang Hospital (Paed) Pulau Pinang Hospital

Pusat Perubatan Universiti Kebangsaan Malaysia Queen Elizabeth Hospital

Raja Perempuan Zainab II Hospital Raja Permaisuri Bainun Hospital

Renal Dialysis Centre Sarawak General Hospital Selayang Hospital (Paed) Selayang Hospital Serdang Hospital

Sultan Haji Ahmad Shah Hospital Sultan Ismail Hospital (Paed) Sultanah Aminah Hospital Sultanah Bahiyah Hospital Sultanah Nur Zahirah Hospital Tawau Hospital

Tengku Ampuan Afzan Hospital (Paed) Tengku Ampuan Afzan Hospital Tengku Ampuan Rahimah Hospital Tuanku Ja'afar Hospital (Paed) Tuanku Ja'afar Hospital

Universiti Sains Malaysia Hospital University Malaya Medical Centre

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xiv

PARTICIPATING TRANSPLANT FOLLOW-UP CENTRES 2013

Renal transplant follow-up centre CC# AR Renal transplant follow-up centre CC# AR

>=80% >=80% >=80% >=80% No AR >=80% >=80% >=80% No AR >=80% >=80% >=80% No AR >=80% >=80% >=80% >=80% >=80% >=80% >=80% >=80% Yes

Yes Yes Yes No Yes Yes Yes No Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Assunta Hospital

Bintulu Hospital Duchess of Kent Hospital Dungun Hospital Fan Medical Renal Clinic

Hospital Enche' Besar Hajjah Khalsom Hospital Sultanah Nora Ismail Klinik Dr Choo & Liew KPJ Sabah Specialist Hospital Kuala Lumpur Hospital (Paed) Kuala Lumpur Hospital Labuan Hospital Mahkota Medical Centre Melaka Hospital Mersing Hospital Miri Hospital

Pakar Sultanah Fatimah Muar Hospital Pontian Hospital

Prince Court Medical Centre Pulau Pinang Hospital

Pusat Perubatan Universiti Kebangsaan Malaysia

Queen Elizabeth Hospital Raja Perempuan Zainab II Hospital Raja Permaisuri Bainun Hospital Sarawak General Hospital Segamat Hospital Selayang Hospital Serdang Hospital Sibu Hospital

Sultan Ismail Hospital (Paed) Sultan Ismail Pandan Hospital Sultanah Aminah Hospital Sultanah Bahiyah Hospital Sultanah Nur Zahirah Hospital Taiping Hospital

Tan Medical Renal Clinic Tawau Hospital

Tg. Ampuan Afzan Hospital Tg. Ampuan Rahimah Hospital Tuanku Ja'afar Hospital

Universiti Sains Malaysia Hospital University Malaya Medical Centre

Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes

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xv

CONTRIBUTING AUTHORS

CHAPTER TITLE AUTHORS INSTITUTIONS

1 ALL RENAL REPLACEMENT THERAPY IN MALAYSIA

Lim Yam Ngo Kuala Lumpur Hospital

Ong Loke Meng Pulau Pinang Hospital

Goh Bak Leong Serdang Hospital

Lee Day Guat National Renal Registry

2 DIALYSIS IN MALAYSIA

Ong Loke Meng Penang Hospital

Ghazali B Ahmad Kuala Lumpur Hospital

Lee Day Guat National Renal Registry

3 DEATH AND SURVIVAL ON DIALYSIS Wong Hin Seng Selayang Hospital

Ong Loke Meng Penang Hospital

4 QOL AND REHABILITATION OUTCOMES ON DIALYSIS PATIENT IN MALAYSIA

Liu Wen Jiun Sultanah Aminah Hospital

Chew Thian Fook Seremban Specialist Hospital

Christopher Lim Thiam Seong University Putra Malaysia

Tan Wee Ming Sunway Medical Centre

Yia @ Yeow Hua Jern Hospital Pakar Sultanah Fatimah

5 PAEDIATRIC RENAL REPLACEMENT THERAPY

Lee Ming Lee Tuanku Ja'afar Hospital

Lynster Liaw Chiew Tung Penang Hospital

Susan Pee Sultan Ismail Hospital

Wan Jazilah Wan Ismail Selayang Hospital

Yap Yoke Chin Kuala Lumpur Hospital

6 MANAGEMENT OF ANAEMIA IN DIALYSIS PATIENTS

Philip N. Jeremiah KPJ Ampang Puteri Specialist Hospital

Bee Boon Cheak Selayang Hospital

Ghazali B Ahmad Kuala Lumpur Hospital

Lim Soo Kun University Malaya Specialist Centre

Zawawi B Nordin Sultanah Nur Zahirah Hospital

7 NUTRITIONAL STATUS ON DIALYSIS

Abdul Halim B Abdul Gafor Pusat Perubatan Universiti Kebangsaan _Malaysia Winnie Chee Siew Swee International Medical University

Tilakavati Karupaiah Faculty of Allied Health Sciences University Kebangsaan Malaysia

Koh Keng Hee Sarawak General Hospital

Ahmad Fauzi B Abd Rahman Puteri Specialist Hospital

8 BLOOD PRESSURE CONTROL AND DYSLIPIDAEMIA

S. Prasad Menon Sime Darby Medical Centre Subang Jaya

Hooi Lai Seong Sultanah Aminah Hospital

Lee Wan Tin Sime Darby Medical Centre Subang Jaya

Sunita Bavanandan Kuala Lumpur Hospital

9 CHRONIC KIDNEY DISEASE - MINERAL AND BONE DISORDERS

Kok Lai Sun Bukit Mertajam Hospital

Rozina Bt Ghazalli Pulau Pinang Hospital

Ching Chen Hua Sultanah Bahiyah Hospital

Fan Kin Sing Gleneagles Intan Medical Centre

Liew Yew Fong Pulau Pinang Hospital

10 HEPATITIS ON DIALYSIS

Clare Tan Hui Hong Sarawak General Hospital

Teo Sue Mei Putri Haemodialysis Centre (Ipoh)

Chow Yok Wai Pantai Air Keroh Hospital

Thiruventhiran Thilaganathan Sunway Medical Centre

Ng Eng Khim TAR University

11 HEAEMODIALYSIS PRACTICES

Shahnaz Shah Firdaus Khan Tengku Ampuan Rahimah Hospital

Tan Chwee Choon Tengku Ampuan Rahimah Hospital

Norleen Bt Zulkarnain Sim Tengku Ampuan Rahimah Hospital

Raﬁdah Abdullah Sultan Haji Ahmad Shah Hospital

12 CHRONIC PERITONEAL DIALYSIS PRACTICES

Sunita Bavanandan Kuala Lumpur Hospital

Lily Mushahar Tuanku Ja'afar Hospital

Anita Bhajan Manocha Hospital Seberang Jaya

13 RENAL TRANSPLANTATION

Rosnawati Yahya Kuala Lumpur Hospital

Fan Kin Sing Gleneagles Intan Medical Centre

S. Prasad Menon Sime Darby Medical Centre Subang Jaya

Tan Si Yen Prince Court Medical Centre

Wong Hin Seng Selayang Hospital

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xvi

Despite many uncertainties in many areas in health sector in this country, the production of the Annual Report of the Malaysian Dialysis and Transplant Registry will be an exception as uninterrupted annual publication now enters its 21st_{year of existence. Notwithstanding}

the challenges associated with the ever growing number of incident and prevalent patients with CKD5D and CKDT as well as the number of SDPs which totaled 780 last year, the dedication and enthusiasm of various individuals and parties did ensure that we reach the readers and MDTR users once again in a timely manner.

As usual, the latest MDTR reports are expected to be used and cited by many interested parties including clinicians, health industry, policy makers, health planners, health regulators and even lawmakers. At the international front, MDTR data made its way, as in its past years, to USRDS and the Global Report on Transplantation for the World Health Organisation. For these reasons, it becomes a paramount importance for the NRR to ensure that the data reported in the annual MDTR achieve a high degree of credibility. Even though data submission by the data providers started on voluntary basis and remained so for many years, the requirements under the Private Healthcare and Facilities Regulations 2006 and the Accreditation of Haemodialysis Services by the Malaysian Society for Quality in Health, Malaysia 2013, made it incumbent on the 600 odd haemodialysis units in the country, both public and private, to submit various data in the form of Annual Returns, Patient and Outcome Notiﬁcation and Annual Surveys to the registry.

In the near future, it is expected that some form of checks and audits will be performed on the data submitted by the SDPs to verify their accuracy. On a longer term basis, it is possible that further transparency will be demanded by the public as well as the funding agencies to get the dialysis centres’ performance to be published and the respective centres be identiﬁed openly for comparisons. This practice is already taking place in several European countries and is just a matter of time before its application locally.

On behalf of the registry Advisory Committee, I wish to express my utmost appreciation to all the ﬁnancial sponsors, in particular Roche Malaysia Sdn Bhd, which had shown their continued generosity and commitment to support NRR. The Source Data Providers who had diligently and consistently submit useful and quality data annually, continue to encourage us to persist with the registry works despite all its challenges. The Expert Committee members who persevered in their volunteerism provided important and relevant commentaries on the important observations associated with the registry data and trends remain an all important part of the registry contributors. The new Editorial Board led jointly by Dr. Goh Bak Leong and Dato’ Dr. Ong Loke Meng had been able to take on the challenges to get the` jobs done’ and completed. The unsurpassed commitments and perseverance of the NRR administrators led by Staff Nurse Lee Day Guat will not go unnoticed, worthy of special mention and are deﬁnitely appreciated.

Thank you all.

Datuk Dr. Ghazali Ahmad Chairman

Advisory Committee 2012-2014 National Renal Registry

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xvii

Acknowledgement

NRR Advisory Board Members

About The Malaysian Dialysis and Transplant Registry (MDTR Participating Haemodialsyis Centres

Participating Chronic Peritoneal Dialsysis Centres Participating Transplant Follow-up Centres Contributing Editors

Foreword

Chapters & Sections List of Tables List of Figures Executive Summary Abbrevation

iii iv v vii - xiii xiii xiv xv xvi xvii - xiv xx - xxv xxvi - xxx xxxi xxxii

LIST OF TABLES

Table 1.1: Table 1.2: Table 1.3: Table 2.1.1(a): Table 2.1.1(b): Table 2.1.1(c): Table 2.1.1(d): Table 2.1.2: Table 2.1.3(a): Table 2.1.3(b): Table 2.1.4 (a): Table 2.1.4 (b): Table 2.1.5: Table 2.1.6: Table 2.1.7: Table 2.1.8: Table 2.2.1: Table 2.2.2: Table 2.2.3: Table 2.2.4: Table 2.2.5: Table 2.2.6: Table 2.2.7: Table 2.2.8: Table 2.2.9: Table 3.1.1: Table 3.1.2: Table 3.2.1(a): Table 3.2.1(b): Table 3.2.2: Table 3.2.3: Table 3.2.4: Table 3.4.1: Table 3.4.2: Table 3.4.3: Table 4.1: Table 4.2: Table 4.3: Table 4.4: Table 4.5: Table 4.6: Table 4.7: Table 4.8: Table 4.9: Table 5.1: Table 5.2: Table 5.3(a): Table 5.3(b): Table 5.4: Table 5.5: Table 5.6: Table 5.7:

2 3 3 6 6 6 6 7 7 8 8 9 9 10 11 11 12 14 16 18 20 22 24 26 28 32 33 34 35 36 37 38 41 44 46 50 50 50 51 51 51 52 52 52 54 55 56 56 56 57 57 57 Stock and flow of RRT, Malaysia 2004-2013

New dialysis acceptance rate and new transplant rate per million population, 2004-2013 RRT prevalence rate per million population, 2004-2013

Stock and flow-Haemodialysis Patients 2004-2013 Stock and flow- Chronic PD Patients 2004-2013

Haemodialysis Treatment Rate per million population 2004-2013 Chronic PD Treatment Rate per million population 2004-2013 Dialysis Treatment Rate by state, per million population 2004-2013

Dialysis Treatment Rate by Gender, per million male or female population 2004-2013 Gender Distribution of Dialysis Patients 2004-2013

Dialysis Treatment Rate by Age Group, per million age group population 2004-2013 Percentage Age Distribution of Dialysis Patients 2004-2013

Method and Location of Dialysis Patients 2004-2013 Funding for Dialysis Treatment 2004-2013 Distribution of Dialysis Patients by Sector 2004-2013 Primary Renal Diseases 2004-2013

Number and density of Dialysis Centres in Malaysia by State and Sector, Year 2004 to 2013 Number and density of HD centres in Malaysia by State and Sector, 2004-2013

Number and density of PD centres in Malaysia by State and Sector, 2004-2013 Number and density of HD machines in Malaysia by State and Sector, 2004-2013

Number and Prevalence Rate of Dialysis Patients (HD & PD) in Malaysia by State and Sector, 2004-2013 Number and Prevalence Rate of Hemodialysis Patients in Malaysia by State and Sector, 2004-2013 Number and Prevalence Rate of PD Patients in Malaysia by State and Sector, 2004-2013 HD Capacity to Patient Ratio among HD Centres in Malaysia by State and Sector, 2004-2013

Number & density of Certified Dialysis Nurses/ Medical technicians in Malaysia by State and Sector, 2004-2013 Deaths on dialysis 2004-2013

Causes of death on dialysis 2004-2013

Patient survival by dialysis modality analysis (censored for change of modality) Patient survival by dialysis modality analysis (not censored for change of modality) Unadjusted patient survival by year of entry, 2004-2013

Unadjusted patient survival by age, 2004-2013

Unadjusted patient survival by diabetes mellitus status, 2004-2013

Adjusted hazard ratio for mortality of dialysis patients uncensored for change of modality (2004-2013) Adjusted hazard ratio for mortality of HD patients uncensored for change of modality (2004-2013 cohort) Adjusted hazard ratio for mortality of PD patients uncensored for change of modality (2004-2013 cohort) Cumulative distribution of QoL-Index score in relation to dialysis modality, all dialysis patients 2004-2013 Cumulative distribution of QoL-Index score in relation to DM, all dialysis patients 2004-2013

Cumulative distribution of QoL-index score in relation to gender, all dialysis patients 2004-2013 Cumulative distribution of QoL-index score in relation to age, all dialysis patients 2004-2013 Cumulative distribution of QoL-Index score in relation to year of entry, HD patients 2004-2013 Cumulative distribution of QoL-Index score in relation to year of entry, PD patients 2004-2013 Work related rehabilitation in relation to modality, dialysis patients, 2004-2013

Work related rehabilitation in relation to year of entry, HD patients 2004-2013 Work related rehabilitation in relation to year of entry, PD patients 2004-2013 Stock and flow of Paediatric Renal Replacement Therapy (RRT), 2004-2013 Paediatric dialysis and transplant rates per million age related population, 2004-2013 Dialysis treatment rate by state, per million state age related population, 2004-2013 New dialysis patients by state, 2004-2013

Number of new dialysis and transplant patients by gender, 2004-2013 New RRT rate, per million age related population by age group, 2004-2013 New dialysis by treatment modality, 2004-2013

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xxi

LIST OF TABLES

(CONT.)

Table 5.8: Table 5.9: Table 5.10(a): Table 5.10(b): Table 5.11: Table 5.12: Table 5.13: Table 5.14: Table 5.15: Table 5.16: Table 5.17(a): Table 5.17(b): Table 5.17(c): Table 5.18: Table 5.19: Table 5.20: Table 5.21: Table 6.1.1: Table 6.1.2: Table 6.1.3: Table 6.1.4: Table 6.1.5: Table 6.1.6: Table 6.1.7: Table 6.1.8: Table 6.2.1: Table 6.2.2: Table 6.2.3: Table 6.2.4: Table 6.2.5: Table 6.2.6: Table 6.2.7: Table 6.2.8: Table 6.2.9(a): Table 6.2.9(b): Table 6.2.9(c): Table 6.2.9(d): Table 6.2.10(a): Table 6.2.10(b): Table 6.2.10(c): Table 6.2.10(d): Table 6.3.1: Table 6.3.2: Table 6.3.3(a): Table 6.3.3(b): Table 6.3.4(a): Table 6.3.4(b): Table 6.3.5(a): Table 6.3.5(b): Table 6.3.6(a): Table 6.3.6(b): Table 7.1.1:

58 58 59 59 60 60 60 61 61 61 62 62 62 62 63 63 63 66 66 67 67 68 68 69 69 70 70 71 71 72 72 73 73 74 74 75 75 76 76 77 77 78 78 79 79 80 80 81 81 82 82 84 Primary renal disease by sex among new dialysis patients, 2004-2013

Types of renal transplantation, 2004-2013

Patient survival by dialysis modality analysis (not censored with change of modality), 2004-2013 Patient survival by dialysis modality analysis (censored with change of modality), 2004-2013 Dialysis technique survival by modality, 2004-2013

Transplant graft survival, 2004-2013

Reasons for drop-out from PD program, 2004-2013 Transplant graft survival, 2004-2013

Causes of graft loss, 2004-2013

Vascular access on haemodialysis, 2004-2013 Distribution of prescribed Kt/V, HD patients 2009-2012 Distribution of delivered Kt/V, HD patients 2009-2013 Distribution of URR, HD patients 2009-2013 Treatment for anaemia, HD patients 2004-2013

Distribution of transferrin saturation on Erythropoietin, HD patients 2004-2013 Distribution of transferrin saturation on Erythropoietin, PD patients 2004-2013 Distribution of ESA dose (u/kg/wk), 2004-2013

Treatment for anaemia, HD patients 2004-2013 Treatment for anaemia, PD patients 2004-2013

Variation in Erythropoiesis-Stimulating Agents (ESAs) utilization (% patients) among HD centres, 2004-2013 Variation in ESAs utilization (% patients) among PD centres, 2004-2013

Variation in mean weekly ESAs dose (u/week) among HD centres, 2004-2013 Variation in mean weekly ESAs dose (u/week) among PD centres, 2004-2013 Variation in use of blood transfusion (% patients) among HD centres, 2004-2013 Variation in use of blood transfusion (% patients) among PD centres, 2004-2013 Distribution of serum ferritin without ESAs, HD patients 2004-2013

Distribution of serum ferritin without ESAs, PD patients 2004-2013 Distribution of serum ferritin on ESAs, HD patients 2004-2013 Distribution of serum ferritin on ESAs, PD patients 2004-2013

Distribution of transferrin saturation without ESAs, HD patients, 2004-2013 Distribution of transferrin saturation without ESAs, PD patients, 2004-2013 Distribution of transferrin saturation on ESAs, HD patients, 2004-2013 Distribution of transferrin saturation on ESAs, PD patients, 2004-2013

Variation in Medium serum ferritin among patients on ESAs, HD centres 2004-2013 Proportion of patients on ESAs with serum ferritin ≥100 ng/ml, HD centres Median transferrin saturation among patients on ESAs, HD centres Proportion of patients on ESAs with transferrin saturation ≥20%, HD centres Variation in medium serum ferritin among patients on ESAs, PD centres 2004-2013 Proportion of patients on ESAs with serum ferritin ≥100 ng/ml, PD centres Median transferrin saturation among patients on ESAs, PD centres

Proportion of patients on ESAs with transferring saturation ≥20%, PD centres Distribution of haemoglobin concentration without ESAs, HD patients 2004-2013 Distribution of haemoglobin concentration without ESAs, PD patients 2004-2013 Distribution of haemoglobin concentration on ESAs, diabetes HD patients 2004-2013 Distribution of haemoglobin concentration on ESAs, non-diabetes HD patients 2004-2013 Distribution of haemoglobin concentration on ESAs, diabetes PD patients 2004-2013 Distribution of haemoglobin concentration on ESAs, non-diabetes PD patients 2004-2013 Variation in median haemoglobin level among patients on ESAs, HD centres 2004-2013 Proportion of patients on ESAs with haemoglobin level > 10g/dL, HD centres

Variation in Median haemoglobin level among patients on ESAs, PD centres 2004-2013 Proportion of patients on ESAs with haemoglobin level >10g/dL, PD centres

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xxii

LIST OF TABLES

(CONT.)

Table 7.1.2: Table 7.1.3: Table 7.1.4: Table 7.2.1: Table 7.2.2: Table 7.2.3: Table 7.2.4: Table 7.2.5: Table 7.2.6: Table 7.3.1: Table 7.3.2(a): Table 7.3.2(b): Table 7.3.3(a): Table 7.3.3(b): Table 8.1.1: Table 8.1.2: Table 8.1.3: Table 8.1.4: Table 8.1.5(a): Table 8.1.5(b): Table 8.1.5(c): Table 8.1.6(a): Table 8.1.6(b): Table 8.1.6(c): Table 8.1.7(a): Table 8.1.7(b): Table 8.2.1: Table 8.2.2: Table 8.2.3: Table 8.2.4: Table 8.2.5(a): Table 8.2.5(b): Table 8.2.5(c): Table 8.2.5(d): Table 8.2.6(a): Table 8.2.6(b): Table 8.2.6(c): Table 8.2.6(d): Table 8.2.7(a): Table 8.2.7(b): Table 9.1.1: Table 9.1.2: Table 9.1.3: Table 9.2.1: Table 9.2.2: Table 9.2.3: Table 9.2.4: Table 9.2.5: Table 9.2.6: Table 9.2.7(a): Table 9.2.8(a): Table 9.2.7(b):

85 85 86 86 87 87 88 88 89 89 89 90 90 90 92 93 93 94 95 96 96 97 98 98 99 100 100 101 101 102 103 103 104 105 105 106 107 107 108 109 112 112 113 114 114 115 115 116 116 117 117 118 Distribution of serum albumin, PD patients, 2004-2013

Variation in proportion of patients with serum albumin ≥40g/L among HD centres 2004-2013 Variation in proportion of patients with serum albumin ≥40g/L among PD centres 2004-2013 Distribution of BMI, HD patients, 2004-2013

Distribution of BMI, PD patients 2004-2013

Variation in proportion of patients with BMI ≥18.5 among HD centres 2004-2013 Variation in proportion of patients with BMI ≥18.5 among PD centres 2004-2013

Variation in proportion of patients with BMI _≥18.5 and serum albumin _≥40 g/dL among HD centres 2004-2013 Variation in proportion of patients with BMI _≥18.5 and serum albumin _≥40 g/dL among PD centres 2004-2013 Nutritional parameters between HD and PD patients, 2013

Nutritional parameters between diabetic and non- diabetic HD patients, 2013 Nutritional parameters between diabetic and non-diabetic PD patients, 2013

Distribution of serum albumin and BMI by duration of dialysis among HD patients, 2004-2013 Distribution of serum albumin and BMI by duration of dialysis among PD patients, 2004-2013 Distribution of pre dialysis systolic blood pressure, HD patients 2004-2013

Distribution of pre dialysis systolic blood pressure, PD patients 2004-2013 Distribution of pre dialysis diastolic blood pressure, HD patients 2004-2013 Distribution of pre dialysis diastolic blood pressure, PD patients 2004-2013 Median systolic blood pressure among HD patients, HD centres

Median diastolic blood pressure among HD patients, HD centres

Proportion of HD patients with pre dialysis blood pressure ≤140/90 mmHg, HD centres Median systolic blood pressure among PD patients, PD centres 2004-2013

Median diastolic blood pressure among PD patients, PD centres 2004-2013

Proportion of PD patients with pre dialysis blood pressure ≤140/90 mmHg, PD centres 2004-2013

Correlation of blood pressure profile and death, cardiovascular death and ischaemic heart disease, dialysis patients 2004-2013 Hazard ratio for death in each of the blood pressure categories, 2004-2013

Distribution of serum cholesterol, HD patients 2004-2013 Distribution of serum cholesterol, PD patients 2004-2013 Distribution of serum triglyceride, HD patients 2004-2013 Distribution of serum triglyceride, PD patients 2004-2013

Median serum cholesterol level among HD patients, HD centres 2004-2013

Proportion of HD patients with serum cholesterol ≤5.3mmol/L, HD centres 2004-2013 Median serum triglyceride level among HD patients, HD centres 2004-2013

Proportion of HD patients with serum triglyceride ≤2.1 mmol/L, HD centres Median serum cholesterol level among PD patients, PD centres 2004-2013

Proportion of PD patients with serum cholesterol _≤5.3 mmol/L, PD centres 2004-2013 Median serum triglyceride level among PD patients, PD centres 2004-2013

Proportion of PD patients with serum triglyceride _≤ 2.1 mmol/L, PD centres 2004-2013 Relationship of different categories of cholesterol levels with death, dialysis patients 2004 -2013 Hazard ratio for death in each of the total cholesterol categories, dialysis patient 2004-2013 Phosphate Binder in HD patients, 2004-2013

Phosphate Binder in PD patients, 2004-2013 Phosphate Binders by Sector in HD patients

Distribution of corrected serum calcium, HD patients 2004-2013 Distribution of corrected serum calcium, PD patients 2004-2013 Distribution of serum phosphate, HD patients 2004-2013 Distribution of serum phosphate, PD patients 2004-2013

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xxiii

LIST OF TABLES

(CONT.)

Table 9.2.8(b): Table 9.2.9(a): Table 9.2.10(a): Table 9.2.9(b): Table 9.2.10(b): Table 9.2.9(c): Table 9.2.10(c): Table 9.2.11(a): Table 9.2.12(a): Table 9.2.11(b): Table 9.2.12(b): Table 9.3.1(a): Table 9.3.1(b): Table 9.3.2(a): Table 9.3.2(b): Table 9.3.2(c): Table 9.3.3(a): Table 9.3.3(b): Table 9.3.3(c): Table 9.3.4(a): Table 9.3.4(b): Table 9.3.5(a): Table 9.3.5(b): Table 10.1: Table 10.2: Table 10.3: Table 10.4: Table 10.5: Table 10.6: Table 11.1.1: Table 11.1.2: Table 11.1.3: Table 11.2.1: Table 11.2.2: Table 11.2.3: Table 11.2.4: Table 11.2.5: Table 11.2.6(a): Table 11.2.6(b): Table 11.2.6(c): Table 11.2.7(a): Table 11.2.7 (b): Table 11.2.7(c): Table 11.2.7(d): Table 11.2.7(e): Table 11.2.7(f): Table 11.2.7(g): Table 11.2.7(h): Table 11.2.7(i): Table 11.3.1(a): Table 11.3.1(b): Table 11.3.2(a):

118 119 119 120 120 121 121 122 122 123 123 124 124 125 125 126 126 127 127 128 128 129 129 132 132 132 133 133 134 136 136 137 138 139 139 140 141 142 142 143 144 144 145 145 146 146 147 147 147 148 149 149 Proportion of patients with serum calcium 2.1 to 2.37 mmol/L, PD centres

Variation in median serum phosphate level among HD centres, 2004-2013 Variation in median serum phosphate levels among PD centres 2004-2013

Proportion of patients with serum phosphate 1.13-1.78 mmol/L, HD centres 2004-2013 Proportion of patients with serum phosphate 1.13-1.78 mmol/L, PD centres 2004-2013 Proportion of patients with serum phosphate 0.8-1.3 mmol/L, HD centres 2013 Proportion of patients with serum phosphate 0.8-1.3 mmol/L, PD centres 2013 Variation in corrected median calcium x phosphate product HD centres 2004-2013 Variation in corrected median calcium x phosphate product PD centres 2004-2013

Proportion of patients with corrected calcium x phosphate _≤4.5 mmol2/L2, HD centres 2004-2013 Proportion of patients with corrected calcium x phosphate _≤4.5 mmol2/L2, PD 2004-2013 Treatment of hyperparathyroidism in HD patients, 2004-2013

Treatment of hyperparathyroidism in PD patients, 2004-2013 Distribution of iPTH, HD patient 2004-2013

Distribution of iPTH, diabetic HD patients 2004-2013 Distribution of iPTH, non-diabetic HD patients 2004-2013 Distribution of iPTH, PD patients 2004-2013

Distribution of iPTH, diabetic PD patients, 2004-2013 Distribution of iPTH, non diabetic PD patients 2004-2013 Variation in iPTH among HD centres 2004-2013

Variation in proportion of patients with iPTH 150-300pg/ml, HD centres 2004-2013 Variation in median iPTH among PD patients 2004-2013

Proportion of patients with iPTH 150-300pg/ml

Prevalence of positive HBsAg and positive Anti-HCV at annual survey, HD patients 2004-2013 Prevalence of positive HBsAg and positive Anti-HCV at annual survey, PD patients 2004-2013 Variation in Proportion of patients with positive HBsAg at annual survey among HD centres, 2004-2013 Variation in proportion of patients with positive HBsAg at annual survey among PD centres, 2004-2013 Variation in proportion of patients with positive anti-HCV at annual survey among HD centres, 2004-2013 Variation in proportion of patients with positive anti-HCV at annual survey among PD centres, 2004-2013 Vascular access on haemodialysis, 2004-2013

Difficulties report with vascular access, 2004-2013 Complications reported with vascular access, 2004-2013 Blood flow rates in HD centers, 2004-2013

Number of HD sessions per week, 2004-2013 Duration of HD, 2004-2013

Dialyser membrane types in HD centres, 2004-2013 Dialyser reuse frequency in HD centres, 2004-2013 Distribution of prescribed Kt/V, HD patients 2004-2013 Distribution of delivered Kt/V, HD patients 2009-2013 Distribution of URR, HD patients 2009-2013

Variation in median blood flow rates in HD patients, HD centres, 2004-2013 Proportion of patients with blood flow rates _≥300 ml/min, HD centres 2004-2013 Proportion of patients with 3 HD sessions per week, HD centres 2004-2013 Median prescribed Kt/V in HD patients, HD centres 2004-2013

Proportion of patients with prescribed Kt/V _≥1.3, 2004-2013 Median delivered Kt/V in HD patients, HD centres 2009-2013 Proportion of patients with delivered Kt/V ≥1.2, HD centres 2009-2013 Median URR among HD patients, HD centres 2009-2013

Proportion of HD patients with URR ≥65%, HD centres 2009-2013 Unadjusted technique survival by year of entry, 2004-2013

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xxiv

LIST OF TABLES

(CONT.)

Table 11.3.2(b): Table 11.3.3(a): Table 11.3.3(b): Table 12.1.1: Table 12.1.2: Table 12.1.3(a): Table 12.1.3(b): Table 12.1.4: Table 12.2.1: Table 12.2.2: Table 12.2.3: Table 12.2.4: Table 12.2.5: Table 12.3.1(a): Table 12.3.1(b): Table 12.3.2(a): Table 12.3.2(b): Table 12.3.3(a): Table 12.3.3(b): Table 12.3.4(a): Table 12.3.4(b): Table 12.3.5: Table 12.3.6: Table 12.3.7(a): Table 12.3.7(b): Table 12.3.8: Table 12.4.1: Table 12.4.2(a): Table 12.4.3(b): Table 12.4.4: Table 13.1.1: Table 13.1.2: Table 13.1.3: Table 13.1.4: Table 13.2.1: Table 13.2.2: Table 13.3.1: Table 13.3.2: Table 13.3.3: Table 13.3.4: Table 13.4.1: Table 13.4.2: Table 13.4.3: Table 13.4.4: Table 13.5.1(a): Table 13.5.1(b): Table 13.5.2(a): Table 13.5.2(b): Table 13.5.3: Table 13.5.4: Table 13.5.5(a): Table 13.5.5(b):

150 151 152 154 154 155 155 156 157 158 158 158 159 159 160 160 161 162 162 163 163 164 164 166 167 167 167 168 169 170 172 172 172 174 175 175 176 177 179 180 181 182 182 183 184 184 185 185 186 187 187 188 Unadjusted technique survival by age (censored for death & transplant), 2004-2013

Unadjusted technique survival by diabetes status, 2004-2013

Unadjusted technique survival by diabetes status (censored for death & transplant), 2004-2013 Peritoneal dialysis regimes, 2004-2013

CAPD connectology, 2004-2013

CAPD Number of Exchanges per day, 2004-2013 APD dwell volumes per day, 2004-2013 Assistance to Perform PD, 2004-2013

Distribution of delivered Kt/V, PD patients 2004-2013

Variation in proportion of patients with Kt/V _≥1.7 per week among PD centres, 2004-2013 Peritoneal transport status by PET D/P creatinine at 4 hours, new PD patients 2004-2013 Peritoneal Transport Status (PET) with dialysis vintage

Residual Urine Volume

Unadjusted technique survival by era 2004–2008 and 2009–2013 (uncensored for death and transplant) Unadjusted technique survival by era 2004–2008 and 2009–2013 (censored for death and transplant) Unadjusted technique survival by age (uncensored for death and transplant), 2004-2013

Unadjusted technique survival by age (censored for death and transplant), 2004-2013 Unadjusted technique survival by gender (uncensored for death and transplant), 2004-2013 Unadjusted technique survival by gender (censored for death and transplant), 2004-2013

Unadjusted technique survival by diabetes status (uncensored for death and transplant), 2004-2013 Unadjusted technique survival by diabetes status (censored for death and transplant), 2004-2013 Unadjusted technique survival by Kt/V, 2004-2013

Adjusted hazard ratio for change of modality, 2004-2013 Reasons for drop-out from PD program, 2004-2013

Drop-out rate from PD program with time on treatment, 2004-2013 Time on PD (2004-2013)

Variation of peritonitis rate (pt-month/epi) among PD centres, 2004-2013 Causative organism in PD peritonitis, 2004-2013

Outcome of peritonitis by causative organism, 2009-2013 Risk factors influencing peritonitis rate, 2004-2013 Stock and flow of renal transplantation, 2004-2013 New transplant rate per million population (pmp), 2004-2013 Transplant prevalence rate per million population (pmp), 2004-2013 Place of transplantation, 2004-2013

Renal transplant recipients’ characteristics, 2004-2013 Primary causes of end stage renal failure, 2004-2013 Type of renal transplantation, 2004-2013

Biochemical data, 2009-2013

Immunosuppressive Medications, 2009-2013 Non-immunosuppressive medications, 2009-2013 Post-transplant complications, 2009-2013

Transplant patient death rate and graft loss, 2004-2013 Causes of death in transplant recipients, 2004-2013 Causes of graft failure, 2004-2013

Patient survival, 2004-2013

Risk factors for transplant patient survival 2004-2013 Graft survival, 2004-2013

Risk factors for transplant graft survival 2004-2013 Unadjusted patient survival by type of transplant, 2004-2013 Graft survival by type of transplant, 2004-2013

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xxv

LIST OF TABLES

(CONT.)

Table 13.5.6(a): Table 13.5.6(b): Table 13.6.1: Table 13.6.2(a): Table 13.6.2(b): Table 13.6.3: Table 13.6.4: Table 13.6.5(a): Table 13.6.5(b): Table 13.6.5(c): Table 13.6.6(a): Table 13.6.6(b): Table 13.6.6(c): Table 13.6.6(d): Table 13.6.6(e): Table 13.7.1: Table 13.7.2: Table 13.7.3: Table 13.7.4: Table 13.7.5:

188 189 189 191 191 192 192 193 193 194 194 194 195 195 195 196 196 196 197 197 Patient survival by year of transplant (Commercial cadaver transplant, 2004-2013)

Graft survival by year of transplant (Commercial cadaver transplant, 2004-2013) Risk factors for IHD in renal transplant recipients at year 2009-2013

Systolic BP, 2009-2013 Diastolic BP, 2009-2013 CKD stages, 2009-2013 BMI, 2009-2013 LDL, 2009-2013

Total cholesterol, 2009-2013 HDL, 2009-2013

Treatment for hypertension, 2009-2013

Distribution of systolic BP without anti-hypertensives, 2009-2013 Distribution of diastolic BP without anti-hypertensives, 2009-2013 Distribution of systolic BP on anti-hypertensives, 2009-2013 Distribution of diastolic BP on anti-hypertensives, 2009-2013