In recent years, the prevalence of dialysis has been increasing, creating a burden on the National Health Insurance program. However, this very increase is also an indicator of the improving quality of medical care in Taiwan. (Chi Chiu-chi)

According to statistics for 2002 from the Taiwan Society of Nephrology, Taiwan ranks second globally in the prevalence of end-stage renal disease (ESRD), with one out of every 650 people undergoing dialysis. Taiwan also has the highest incidence of ESRD, as more than 8,000 additional people require this treatment each year.

In 2003, kidney diseases such as nephritis (kidney inflammation), renal syndrome and nephrosis were the eighth leading cause of death among Taiwanese. In that year, 4,306 persons died of kidney disease, making it Taiwan's "new national scourge." Why is this the case? And how can kidney disease be prevented?

It's 7 a.m. and the streets remain tranquil, but An-Der Medical Clinic and Hemodialysis Center on Taipei's Pate Road is already getting busy. Accompanied by their offspring, elderly men and women walk into the dialysis unit hidden within the building.

An-Der has 60 beds for dialysis patients. Beginning at 7 a.m. and continuing until 10:30 p.m., the clinic performs the hemodialysis procedure on more than 100 patients in morning, afternoon, and evening shifts. As at other dialysis centers, the clinic's morning shift sees mostly older patients, while afternoon patients-who are typically part-time workers or those without regular work hours-are fewer in number. Patients who come in during the evening shift are mostly office workers, who arrive after getting off work, carrying their briefcases.

Surprisingly, the atmosphere inside the dialysis center is relaxed. Some people close their eyes meditatively, while others read books or watch television as their dialysis proceeds. Still others eat from take-out boxes as they receive treatment.