Chronic Peritoneal Dialysis in South Asia — Challenges and Future

Aim There is paucity of data on the epidemiology of end‐stage kidney disease (ESKD) from South Asia and South‐East Asia. The objective of this study was to assess the aetiology, practice patterns and disease burden and growth of ESKD in the region comparing the economies. Methods The national nephrology societies of the region; responded to the questionnaire; based on latest registries, acceptable community‐based studies and society perceptions. The countries in the region were classified into Group 1 (High|higher‐middle‐income) and Group 2 (lower|lowermiddle income). Student t‐test, Mann‐Whitney U test and Fisher's exact test were used for comparison. Results Fifteen countries provided the data. The average incidence of ESKD was estimated at 226.7 per million population (pmp), (Group 1 vs. Group 2, 305.8 vs. 167.8 pmp) and average prevalence at 940.8 pmp (Group 1 vs. Group 2, 1306 vs. 321 pmp). Group 1 countries had a higher incidence and prevalence of ESKD. Diabetes, hypertension and chronic glomerulonephritis were most common causes. The mean age in Group 2 was lower by a decade (Group 1 vs. Group 2—59.45 vs 47.7 years). Conclusion Haemodialysis was the most common kidney replacement therapy in both groups and conservative management of ESKD was the second commonest available treatment option within Group 2. The disease burden was expected to grow >20% in 50% of Group 1 countries and 78% of Group 2 countries along with the parallel growth in haemodialysis and peritoneal dialysis.

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“…Few reports were available from the North Central province of Sri Lanka and Udhanam of Srikakulam district in India. 21 …”

Section: Discussionmentioning

confidence: 99%

Aetiology, practice patterns and burden of end‐stage kidney disease in South Asia and South‐East Asia: A questionnaire‐based survey

et al. 2020

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“…In developing countries, financial limitations constrain PD access ( 49 , 63 , 64 , 93 ). It was reported that the annual PD provision costs in those countries are much higher than the per capita gross national income.…”

Section: Lessons Learned and Strategic Recommendationsmentioning

confidence: 99%

A Global Overview of the Impact of Peritoneal Dialysis First or Favored Policies: An Opinion

et al. 2015

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Given the ever-increasing burden of end-stage renal disease (ESRD) in a global milieu of limited financial and health resources, interested parties continue to search for ways to optimize dialysis access. Government and payer initiatives to increase access to renal replacement therapies (RRTs), particularly peritoneal dialysis (PD) and hemodialysis (HD), may have meaningful impacts from clinical and health-economic perspectives; and despite similar clinical and humanistic outcomes between the two dialysis modalities, PD may be the more convenient and resource-conscious option. This review assessed country-specific PD-First/Favored policies and their associated background, implementation, and outcomes. It was found that barriers to policy-implementation are broadly associated with government policy, economics, provider or healthcare professional education, modality-related factors, and patient-related factors. Notably, the success of a given country's PD-Favored policy was inversely associated with the extent of HD infrastructure. It is hoped that this review will provide a foundation across countries to share lessons learned during the development and implementation of PD-First/Favored policies.

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“…To address these problems, we maintained the platelet count at 5×10 4 /mm 3 to prevent surgical intervention-related bleeding and 3×10 4 /mm 3 to prevent exitsite bleeding and unexpected intraabdominal bleeding related to the PD catheter, according to the guidelines for platelet infusions in patients with thrombocytopenia and other reports (9-11). Since PD-related peritonitis mainly occurs due to touch-contamination during the bag-change process at our hospital, as has also been previously reported (16)(17)(18)(19)(20), we introduced a new UV-sterilization device system, called "TSUNAGU" (Baxter Co.), which does not require the removal of the protective cover when connecting a new PDF bag. This system might be better able to maintain a sterile environment during most bag change procedures than the conventional "Clean Flash" UV-device system (Baxter Co.), which requires the protective cap be removed from the connecting tube by hand when changing PDF bags.…”

Section: Discussionmentioning

confidence: 97%

Successful Introduction of Peritoneal Dialysis in an End-stage Renal Failure Patient with Idiopathic Aplastic Anemia

et al. 2020

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A 45-year-old man with idiopathic aplastic anemia required renal replacement therapy (RRT) due to endstage renal disease (ESRD). We succeeded in inserting the peritoneal dialysis (PD) catheter under cover of frequent red blood cell and platelet infusions because of severe pancytopenia. During the one-year period after starting PD using an ultraviolet-ray sterilization device, he developed severe leukopenia but no PD-related peritonitis or exit site/tunnel infection until he died of pneumonia. This case suggests that PD might be a suitable choice as RRT in ESRD patients with aplastic anemia, even in those with severe pancytopenia.

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Chronic Peritoneal Dialysis in South Asia — Challenges and Future

Cited by 27 publications

References 11 publications

Aetiology, practice patterns and burden of end‐stage kidney disease in South Asia and South‐East Asia: A questionnaire‐based survey

Aetiology, practice patterns and burden of end‐stage kidney disease in South Asia and South‐East Asia: A questionnaire‐based survey

A Global Overview of the Impact of Peritoneal Dialysis First or Favored Policies: An Opinion

Successful Introduction of Peritoneal Dialysis in an End-stage Renal Failure Patient with Idiopathic Aplastic Anemia

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