In many developing countries in the South Asian region, screening for chronic diseases in the community has shown a widely varying prevalence. However, certain geographical regions have shown a high prevalence of chronic kidney disease (CKD) of unknown etiology. This predominantly affects the young and middle-aged population with a lower socioeconomic status. Here, we describe the hotspots of CKD of undiagnosed etiology in South Asian countries including the North, Central and Eastern provinces of Sri Lanka and the coastal region of the state of Andhra Pradesh in India. Screening of these populations has revealed cases of CKD in various stages. Race has also been shown to be a factor, with a much lower prevalence of CKD in whites compared to Asians, which could be related to the known influence of ethnicity on CKD development as well as environmental factors. The difference between developed and developing nations is most stark in the realm of healthcare, which translates into CKD hotspots in many regions of South Asian countries. Additionally, the burden of CKD stage G5 remains unknown due to the lack of registry reports, poor access to healthcare and lack of an organized chronic disease management program. The population receiving various forms of renal replacement therapy has dramatically increased in the last decade due to better access to point of care, despite the disproportionate increase in nephrology manpower. In this article we will discuss the nephrology care provided in various countries in South Asia, including India, Bangladesh, Pakistan, Nepal, Bhutan, Sri Lanka and Afghanistan.

This multicenter cohort study of prevalent continuous PD patients in south India showed nondiabetics, average transporters, nonsmokers with reasonable nutritional status, with Hb 11 g/dL, with low peritonitis rate, with over 1 L ultrafiltration volume per day, the great majority that joined the once per lifetime payment scheme, and the reimbursement group survived for 3 years or longer.

There is a dearth otdat a regarding the performan ce a nd survival of long term PH pati ent s. We ret ros pect ively a na lysed three pati ent s who were on CA P Il for nearly ten years from our centre. Ofthese th ree stud ied, two were women, and a man with ag e 49, 43 a nd 56 years re spe ctivel y. AII J were non vegeta ria ns doing 2L X-I excha nges of d ia nea l a nd were anurtc for over 2 years. Mean ultrafiltration volume was 1300mL, 1200m L and 1500mL T h eir last Kt/V was 2, 1,96 a nd 2, The prima ry renal disease was dia betic nephropathy in the mal e an d hype rtensive nephropathy in the 1""0 female. O ne lad y had a dolled allo graft in 2005 which was re mo ved. Male diabeti c patient died after ten years following a fu nga l peritonitis which necessitated cathete r removal.

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