Peritoneal dialysis: Status report in South and South East Asia

Vinant Bhargava; Sanjiv Jasuja; Sydney Chi Wai Tang; Anil K. Bhalla; Gaurav Sagar; Vivekanand Jha; Raja Ramachandran; Manisha Sahay; Suceena Alexander; Tushar Vachharajani; Aida Lydia; Mamun Mostafi; Jayakrishnan K. Pisharam; Chakko Jacob; Atma Gunawan; Goh Bak Leong; Khin Thida Thwin; Rajendra Kumar Agrawal; Kriengsak Vareesangthip; Roberto Tanchanco; Lina Choong; Chula Herath; Chih Ching Lin; Syed Fazal Akhtar; Ali Alsahow; Devender Singh Rana; Mohan M. Rajapurkar; Vijay Kher; Shalini Verma; Sampathkumar Krishnaswamy; Amit Gupta; Anupam Bahl; Ashwani Gupta; Umesh B. Khanna; Santosh Varughese; Maurizio Gallieni

doi:10.1111/nep.13949

Peritoneal dialysis: Status report in South and South East Asia

Vinant Bhargava, Sanjiv Jasuja, Sydney Chi Wai Tang, Anil K. Bhalla, Gaurav Sagar, Vivekanand Jha, Raja Ramachandran, Manisha Sahay, Suceena Alexander, Tushar Vachharajani, Aida Lydia, Mamun Mostafi, Jayakrishnan K. Pisharam, Chakko Jacob, Atma Gunawan, Goh Bak Leong, Khin Thida Thwin, Rajendra Kumar Agrawal, Kriengsak Vareesangthip, Roberto TanchancoLina Choong, Chula Herath, Chih Ching Lin, Syed Fazal Akhtar, Ali Alsahow, Devender Singh Rana, Mohan M. Rajapurkar, Vijay Kher, Shalini Verma, Sampathkumar Krishnaswamy, Amit Gupta, Anupam Bahl, Ashwani Gupta, Umesh B. Khanna, Santosh Varughese, Maurizio Gallieni

Faculty of Medicine

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

Background: Peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) is largely underutilized globally. We analyzed PD utilization, impact of economic status, projected growth and impact of state policy(s) on PD growth in South Asia and Southeast Asia (SA&SEA) region. Methods: The National Nephrology Societies of the region responded to a questionnaire on KRT practices. The responses were based on the latest registry data, acceptable community-based studies and societal perceptions. The representative countries were divided into high income and higher-middle income (HI & HMI) and low income and lower-middle income (LI & LMI) groups. Results: Data provided by 15 countries showed almost similar percentage of GDP as health expenditure (4%–7%). But there was a significant difference in per capita income (HI & HMI -US$ 28 129 vs. LI & LMI - US$ 1710.2) between the groups. Even after having no significant difference in monthly cost of haemodialysis (HD) and PD in LI & LMI countries, they have poorer PD utilization as compared to HI & HMI countries (3.4% vs. 10.1%); the reason being lack of formal training/incentives and time constraints for the nephrologist while lack of reimbursement and poor general awareness of modalities has been a snag for the patients. The region expects ≥10% PD growth in the near future. Hong Kong and Thailand with ‘PD first’ policy have the highest PD utilization. Conclusion: Important deterrents to PD underutilization were lack of PD centric policies, lackadaisical patient/physician's attitude, lack of structured patient awareness programs, formal training programs and affordability.

Original language	English
Pages (from-to)	898-906
Number of pages	9
Journal	Nephrology
Volume	26
Issue number	11
DOIs	https://doi.org/10.1111/nep.13949
Publication status	Published - Nov 2021

Keywords

APD
clinical nephrology
continuous renal replacement therapy
dialysis
end-stage kidney disease
peritoneal dialysis

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10.1111/nep.13949

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Bhargava, V., Jasuja, S., Tang, S. C. W., Bhalla, A. K., Sagar, G., Jha, V., Ramachandran, R., Sahay, M., Alexander, S., Vachharajani, T., Lydia, A., Mostafi, M., Pisharam, J. K., Jacob, C., Gunawan, A., Leong, G. B., Thwin, K. T., Agrawal, R. K., Vareesangthip, K., ... Gallieni, M. (2021). Peritoneal dialysis: Status report in South and South East Asia. Nephrology, 26(11), 898-906. https://doi.org/10.1111/nep.13949

@article{1475f0d0ca0344b5bd8eadf48c53df91,

title = "Peritoneal dialysis: Status report in South and South East Asia",

abstract = "Background: Peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) is largely underutilized globally. We analyzed PD utilization, impact of economic status, projected growth and impact of state policy(s) on PD growth in South Asia and Southeast Asia (SA&SEA) region. Methods: The National Nephrology Societies of the region responded to a questionnaire on KRT practices. The responses were based on the latest registry data, acceptable community-based studies and societal perceptions. The representative countries were divided into high income and higher-middle income (HI & HMI) and low income and lower-middle income (LI & LMI) groups. Results: Data provided by 15 countries showed almost similar percentage of GDP as health expenditure (4%–7%). But there was a significant difference in per capita income (HI & HMI -US$ 28 129 vs. LI & LMI - US$ 1710.2) between the groups. Even after having no significant difference in monthly cost of haemodialysis (HD) and PD in LI & LMI countries, they have poorer PD utilization as compared to HI & HMI countries (3.4% vs. 10.1%); the reason being lack of formal training/incentives and time constraints for the nephrologist while lack of reimbursement and poor general awareness of modalities has been a snag for the patients. The region expects ≥10% PD growth in the near future. Hong Kong and Thailand with {\textquoteleft}PD first{\textquoteright} policy have the highest PD utilization. Conclusion: Important deterrents to PD underutilization were lack of PD centric policies, lackadaisical patient/physician's attitude, lack of structured patient awareness programs, formal training programs and affordability.",

keywords = "APD, clinical nephrology, continuous renal replacement therapy, dialysis, end-stage kidney disease, peritoneal dialysis",

author = "Vinant Bhargava and Sanjiv Jasuja and Tang, {Sydney Chi Wai} and Bhalla, {Anil K.} and Gaurav Sagar and Vivekanand Jha and Raja Ramachandran and Manisha Sahay and Suceena Alexander and Tushar Vachharajani and Aida Lydia and Mamun Mostafi and Pisharam, {Jayakrishnan K.} and Chakko Jacob and Atma Gunawan and Leong, {Goh Bak} and Thwin, {Khin Thida} and Agrawal, {Rajendra Kumar} and Kriengsak Vareesangthip and Roberto Tanchanco and Lina Choong and Chula Herath and Lin, {Chih Ching} and Akhtar, {Syed Fazal} and Ali Alsahow and Rana, {Devender Singh} and Rajapurkar, {Mohan M.} and Vijay Kher and Shalini Verma and Sampathkumar Krishnaswamy and Amit Gupta and Anupam Bahl and Ashwani Gupta and Khanna, {Umesh B.} and Santosh Varughese and Maurizio Gallieni",

note = "Publisher Copyright: {\textcopyright} 2021 Asian Pacific Society of Nephrology.",

year = "2021",

month = nov,

doi = "10.1111/nep.13949",

language = "English",

volume = "26",

pages = "898--906",

journal = "Nephrology",

issn = "1320-5358",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "11",

}

Bhargava, V, Jasuja, S, Tang, SCW, Bhalla, AK, Sagar, G, Jha, V, Ramachandran, R, Sahay, M, Alexander, S, Vachharajani, T, Lydia, A, Mostafi, M, Pisharam, JK, Jacob, C, Gunawan, A, Leong, GB, Thwin, KT, Agrawal, RK, Vareesangthip, K, Tanchanco, R, Choong, L, Herath, C, Lin, CC, Akhtar, SF, Alsahow, A, Rana, DS, Rajapurkar, MM, Kher, V, Verma, S, Krishnaswamy, S, Gupta, A, Bahl, A, Gupta, A, Khanna, UB, Varughese, S & Gallieni, M 2021, 'Peritoneal dialysis: Status report in South and South East Asia', Nephrology, vol. 26, no. 11, pp. 898-906. https://doi.org/10.1111/nep.13949

TY - JOUR

T1 - Peritoneal dialysis

T2 - Status report in South and South East Asia

AU - Bhargava, Vinant

AU - Jasuja, Sanjiv

AU - Tang, Sydney Chi Wai

AU - Bhalla, Anil K.

AU - Sagar, Gaurav

AU - Jha, Vivekanand

AU - Ramachandran, Raja

AU - Sahay, Manisha

AU - Alexander, Suceena

AU - Vachharajani, Tushar

AU - Lydia, Aida

AU - Mostafi, Mamun

AU - Pisharam, Jayakrishnan K.

AU - Jacob, Chakko

AU - Gunawan, Atma

AU - Leong, Goh Bak

AU - Thwin, Khin Thida

AU - Agrawal, Rajendra Kumar

AU - Vareesangthip, Kriengsak

AU - Tanchanco, Roberto

AU - Choong, Lina

AU - Herath, Chula

AU - Lin, Chih Ching

AU - Akhtar, Syed Fazal

AU - Alsahow, Ali

AU - Rana, Devender Singh

AU - Rajapurkar, Mohan M.

AU - Kher, Vijay

AU - Verma, Shalini

AU - Krishnaswamy, Sampathkumar

AU - Gupta, Amit

AU - Bahl, Anupam

AU - Gupta, Ashwani

AU - Khanna, Umesh B.

AU - Varughese, Santosh

AU - Gallieni, Maurizio

PY - 2021/11

Y1 - 2021/11

N2 - Background: Peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) is largely underutilized globally. We analyzed PD utilization, impact of economic status, projected growth and impact of state policy(s) on PD growth in South Asia and Southeast Asia (SA&SEA) region. Methods: The National Nephrology Societies of the region responded to a questionnaire on KRT practices. The responses were based on the latest registry data, acceptable community-based studies and societal perceptions. The representative countries were divided into high income and higher-middle income (HI & HMI) and low income and lower-middle income (LI & LMI) groups. Results: Data provided by 15 countries showed almost similar percentage of GDP as health expenditure (4%–7%). But there was a significant difference in per capita income (HI & HMI -US$ 28 129 vs. LI & LMI - US$ 1710.2) between the groups. Even after having no significant difference in monthly cost of haemodialysis (HD) and PD in LI & LMI countries, they have poorer PD utilization as compared to HI & HMI countries (3.4% vs. 10.1%); the reason being lack of formal training/incentives and time constraints for the nephrologist while lack of reimbursement and poor general awareness of modalities has been a snag for the patients. The region expects ≥10% PD growth in the near future. Hong Kong and Thailand with ‘PD first’ policy have the highest PD utilization. Conclusion: Important deterrents to PD underutilization were lack of PD centric policies, lackadaisical patient/physician's attitude, lack of structured patient awareness programs, formal training programs and affordability.

AB - Background: Peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) is largely underutilized globally. We analyzed PD utilization, impact of economic status, projected growth and impact of state policy(s) on PD growth in South Asia and Southeast Asia (SA&SEA) region. Methods: The National Nephrology Societies of the region responded to a questionnaire on KRT practices. The responses were based on the latest registry data, acceptable community-based studies and societal perceptions. The representative countries were divided into high income and higher-middle income (HI & HMI) and low income and lower-middle income (LI & LMI) groups. Results: Data provided by 15 countries showed almost similar percentage of GDP as health expenditure (4%–7%). But there was a significant difference in per capita income (HI & HMI -US$ 28 129 vs. LI & LMI - US$ 1710.2) between the groups. Even after having no significant difference in monthly cost of haemodialysis (HD) and PD in LI & LMI countries, they have poorer PD utilization as compared to HI & HMI countries (3.4% vs. 10.1%); the reason being lack of formal training/incentives and time constraints for the nephrologist while lack of reimbursement and poor general awareness of modalities has been a snag for the patients. The region expects ≥10% PD growth in the near future. Hong Kong and Thailand with ‘PD first’ policy have the highest PD utilization. Conclusion: Important deterrents to PD underutilization were lack of PD centric policies, lackadaisical patient/physician's attitude, lack of structured patient awareness programs, formal training programs and affordability.

KW - APD

KW - clinical nephrology

KW - continuous renal replacement therapy

KW - dialysis

KW - end-stage kidney disease

KW - peritoneal dialysis

UR - http://www.scopus.com/inward/record.url?scp=85112668449&partnerID=8YFLogxK

U2 - 10.1111/nep.13949

DO - 10.1111/nep.13949

M3 - Article

C2 - 34313370

AN - SCOPUS:85112668449

SN - 1320-5358

VL - 26

SP - 898

EP - 906

JO - Nephrology

JF - Nephrology

IS - 11

ER -

Peritoneal dialysis: Status report in South and South East Asia

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