Persistent abnormalities in kidney structure or function characterize chronic kidney disease (CKD). In Taiwan, CKD affects approximately 11.9% of the adult population, and the country has long ranked among those with the highest incidence and prevalence of end-stage renal disease (ESRD) worldwide.
Kidney disease is the most costly condition covered by Taiwan's National Health Insurance. In 2022, dialysis cost the Taiwan health insurance program 15.7 billion USD, ranking first among all disease categories. Taiwan is also home to more than 770 dialysis centers.
Why is CKD so hard to treat?
- Diverse etiologies: hypertension, diabetes, glomerulonephritis, and nephrotoxin exposure can all drive progressive loss of kidney function.
- Limited animal models: Existing models cannot fully reflect the complexity of human CKD.
- Limited genetic testing yield: Only 1–5% of CKD patients have an identifiable monogenic cause.
- Limitations of kidney function tests: Conventional markers such as eGFR and proteinuria can not accurately reflect underlying structural kidney damage.
- Low biopsy rate: Only a minority of patients undergo kidney biopsy, which limits accurate etiologic diagnosis.
Slow pace of new drug development
Despite recent advances in CKD therapies, including SGLT2 inhibitors, GLP-1 receptor agonists, and nsMRAs, ESRD incidence remains high, highlighting important gaps in our understanding of CKD biology and treatment.
Kidney biopsy-based multi-omics translational research
Integrating kidney tissue analysis with blood and urine multi-omics, the TRTOI cohort redefines kidney disease at the molecular level and drives the development of precision therapies.