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

Research output: Contribution to journalArticlepeer-review

11 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 languageEnglish
Pages (from-to)898-906
Number of pages9
JournalNephrology
Volume26
Issue number11
DOIs
Publication statusPublished - Nov 2021

Keywords

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

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