Dialysis Care and Dialysis Funding in Asia

Sydney C.W. Tang, Xueqing Yu, Hung Chun Chen, Naoki Kashihara, Hyeong Cheon Park, Adrian Liew, Bak Leong Goh, Maria Gina C. Nazareth, Sakarn Bunnag, Jackson Tan, Virithy Lun, Aida Lydia, Sanjib K. Sharma, Ehteshamul Hoque, Ariunaa Togtokh, Mohammad Ghnaimet, Vivekanand Jha

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)


Asia is the largest and most populated continent in the world, with a high burden of kidney failure. In this Policy Forum article, we explore dialysis care and dialysis funding in 17 countries in Asia, describing conditions in both developed and developing nations across the region. In 13 of the 17 countries surveyed, diabetes is the most common cause of kidney failure. Due to great variation in gross domestic product per capita across Asian countries, disparities in the provision of kidney replacement therapy (KRT) exist both within and between countries. A number of Asian nations have satisfactory access to KRT and have comprehensive KRT registries to help inform practices, but some do not, particularly among low- and low-to-middle-income countries. Given these differences, we describe the economic status, burden of kidney failure, and cost of KRT across the different modalities to both governments and patients and how changes in health policy over time affect outcomes. Emerging trends suggest that more affluent nations and those with universal health care or access to insurance have much higher prevalent dialysis and transplantation rates, while in less affluent nations, dialysis access may be limited and when available, provided less frequently than optimal. These trends are also reflected by an association between nephrologist prevalence and individual nations’ incomes and a disparity in the number of nephrologists per million population and per thousand KRT patients.

Original languageEnglish
Pages (from-to)772-781
Number of pages10
JournalAmerican Journal of Kidney Diseases
Issue number5
Publication statusPublished - May 2020


  • Asia
  • China
  • cost of care
  • Dialysis
  • dialysis modality
  • end-stage renal disease (ESRD)
  • geographical differences
  • health care financing
  • health care policy
  • hemodialysis (HD)
  • kidney failure
  • nephrology workforce
  • peritoneal dialysis (PD)
  • renal replacement therapy (RRT)
  • review


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