Hemodialysis versus peritoneal dialysis in resource-limited settings

Abstract

Access to both hemodialysis and peritoneal dialysis remains highly inequitable in lower-resource settings. Although challenges associated with dialysis in low-resource settings are similar, and there are more adults who require dialysis in low-resource settings, addressing hemodialysis and peritoneal dialysis needs of children in low-resource settings requires attention as the global inequities are greatest in this area. Lower-income countries are increasingly seeking to improve access to dialysis through various strategies, but meeting the costs of the entire dialysis population continues to be a major challenge.

Dialysis funding, eligibility, procurement, and protocols in low- and middle-income settings: results from the International Society of Nephrology collection survey

“…Most responses to the survey reflected experience in adult dialysis care, and a large knowledge gap remains in terms of pediatric ESKD care in low-resource settings, where it is known that children have far less access to care and specialist availability is more scarce. 8 Even though ESKD care, including dialysis and transplantation, is available in vast majority of LMIC according to the Global Kidney Health Atlas (GKHA), 9 important barriers in access to ESKD care were identified in this survey. However, there is a striking disparity between availability and access to dialysis treatment within and among countries, which points to important barriers to the implementation of kidney replacement therapy, particularly in low-resource areas.…”

To include or not include: renal dialysis policy in the era of universal health coverage

“…There are two options available for renal dialysis, haemodialysis and peritoneal dialysis, and health outcomes are similar for both 6. Haemodialysis is used most often but incurs high costs and is largely provided in centres in large cities; peritoneal dialysis is generally more cost effective and scalable as it is mainly carried out at home and has lower infrastructural requirements 7…”

Peran Continous Ambulatory Peritoneal Dialysis dalam Pemerataan Layanan Pengganti Ginjal di Indonesia

“…13 Membran peritoneum terdiri dari tiga lapisan, lapisan endotel kapiler, lapisan interstitium peritonuem, dan lapisan mesotelium yang banyak mengandung mikrovili. Pada lapisan mikrovili didapatkan lapisan tipis cairan yang dinamakan phosphotidylcholine yang berfungsi sebagai surfaktan, 14 lapisan ini juga berfungsi untuk melindungi lapisan mesotelium pada saat proses ultrafiltrasi dialisis.…”

“…11 Pada CAPD, proses ultrafiltrasi akan terus berlangsung hingga cairan dialisis berubah menjadi isotonik. 14…”