Global Kidney Health Atlas: a spotlight on the Asia-Pacific sector

Abstract

Chronic kidney disease (CKD) is a unique public health problem in terms of high expenses required for its management and its increasing worldwide incidence. Understanding the existing structure of CKD treatment and its epidemiology is pivotal for equitable kidney care globally. The Global Kidney Health Atlas (GKHA) was launched by the International Society of Nephrology (ISN) in 2017 as a part of its “Bridging the Gaps” strategy with a vision to understand the global kidney care capacity. Two rounds of GKHA surveys were conducted and published in 2017 and 2019, respectively. The GKHA surveys showed significant variability in kidney care among global regions. Asia is the largest of all continents and distinct for its heterogeneity. The Asia-Pacific sector comprises four main regional constructs of the ISN; North and East Asia, Oceania and South East Asia, South Asia, and the Middle East. Kidney care capacity varies among these regions in terms of government spending, epidemiology of kidney diseases, and workforce availability. In this narrative review, we highlight the differences in kidney care delivery among the regions of the Asia-Pacific sector based on information from GKHA and emphasize the priority areas on which stakeholders should concentrate their efforts.

Practice of dialysis access interventional nephrology procedures in the Asia‐Pacific region: Getting lay of the land

“…Although substantial variations in dialysis services across the world have been reported haemodialysis (HD) is the predominant form of dialysis preferred across the world whereas only 11% receive peritoneal dialysis (PD). 4,16,17 Similar trends were observed when we surveyed the APR; more than 65% of the respondents reported HD as the preferred treatment modality. On the other hand, Thailand has initiated a 'PD-first policy' to cut down the dialysis expenses 18 ; 25% of its patients use PD as a treatment modality.…”

“…[27][28][29][30][31] We received variable responses from different institutes of the same country suggesting that in most participating countries the frequency of access monitoring was not defined; it is performed randomly, depending upon the patient's condition. In most APR coun- with a country's GDP 17,33 ; LICs and LMICs from SA and SEA are reported to have poorer dialysis infrastructure and inadequate manpower resulting in higher dialysis dropout rates. 12 There were limitations to our study.…”

Chronic kidney disease of unknown aetiology: A comprehensive review of a global public health problem

“…Shortage of healthcare workforce and poor infrastructure poses a serious challenge to managing the growing burden of CKDu in the affected regions. In South Asia, there are only 1.2 nephrologists per million population (pmp), in comparison to 19.5 in North and East Asia [106]. In the Latin American region, there is again a striking disparity between countries with 45.2 nephrologists pmp in Cuba, and as low as 1–5 in Nicaragua, and 6–10 in El Salvador [107].…”

Fatty Acid β-Oxidation in Kidney Diseases: Perspectives on Pathophysiological Mechanisms and Therapeutic Opportunities

“…Over the last 20 years, approximately 850 million people have been suffering from some form of kidney disease ( Bharati and Jha, 2022 ). Many kidney diseases eventually progress to end-stage renal disease (ESRD) due to the lack of specific treatment drugs.…”