Nephrology in Indonesia

As a developing country and the world's fourth most populous country, Indonesia faces unique challenges in health, including nephrology. Other than the traditional risk factors for kidney diseases such as diabetes and hypertension, Indonesia also has other risk factors affected by its sociocultural and geographical profile, such as tropical infections and administration of certain herbal or other traditional medicine, which may be nephrotoxic and predispose to acute kidney injury. The Indonesian Society of Nephrology was first established in 1976 and gained international recognition in 1978. Hemodialysis remains the most utilized renal replacement therapy modality for patients with end-stage renal disease; peritoneal dialysis and kidney transplants are far less popular. The number of patients with end-stage kidney disease who underwent routine hemodialysis was 132,142 in 2018, almost two times the number of patients in 2017. Kidney transplant procedures are relatively few, but the number of procedures per year and the centers that are available for the procedure keeps increasing. This chapter gives an overview of nephrology in Indonesia and its challenges in tackling the many aspects of nephrology.