What Is the Best Dialysis Therapy for South Asia: HD or PD?

Pavan, K.R.N.; Subhramanyam, Sreepada; Karopadi, Akash Nayak; Sinoj, K.A.; Nayak, K.S.

doi:10.1159/000450687

Cited by 4 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…T he cost of thrice daily peritoneal dialysis (PD) exchanges is similar to thrice weekly hemodialysis (HD) for self-financed patients in India (1). Yet, HD continues to grow exponentially, while PD penetration stands at 8 to 10% (2).…”

mentioning

confidence: 99%

“Why I Chose Hemodialysis over Peritoneal Dialysis”: An Opinion Survey among In-Center Hemodialysis Patients

et al. 2018

View full text Add to dashboard Cite

Peritoneal dialysis (PD) penetration in India remains low despite the huge chronic kidney disease burden and unmet need for renal replacement therapy (RRT). In order to understand the socioeconomic reasons that govern patients' preference for hemodialysis (HD), we carried out an opinion survey among prevalent in-center HD patients at our institution using a multiple response questionnaire that was verbally administered to them at the dialysis facility by the investigators. Close to 80% were self-financed and 49.5% were on twice weekly HD. Despite the majority (95%) receiving RRT education from a nephrologist, 43.4% were not aware of PD as an RRT modality. The treating nephrologist's recommendation was the most important reason given for choosing HD (77.8%) and not choosing PD (69.7%). Other reasons for not choosing PD included lack of a dedicated caregiver or "clean area" at home (15.1%), fear of infection (15.1%), disruption of work (14.1%), and the high cost of PD (7%). The perceived advantages of HD over PD were greater convenience because of need for only twice or thrice weekly sessions (61%), supervised care received in a hospital setting (28.8%), and less disruption of the patient's and family's routine (22%). We discuss the implications of these findings and what policy makers and nephrologists in India and other developing countries can do to improve PD penetration and utilization.

show abstract

mentioning

confidence: 99%

“Why I Chose Hemodialysis over Peritoneal Dialysis”: An Opinion Survey among In-Center Hemodialysis Patients

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Universal reimbursements are rare in this region, and most nations remain dependent on expensive imported KRT technology. Thus, the use of HDF is limited to increasing usage in corporate hospitals or private healthcare settings that cater to wealthy patients and those with access to insurance 22 …”

Section: Epidemiologic Data and Experience Of Hdf In The Developing C...mentioning

confidence: 99%

“…22 2.1.5 | HDF in middle East AsiaA prospective cohort study which analyzed data from DOPPS for the Gulf Cooperation Council (GCC) countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates in 2012-…”

mentioning

confidence: 99%

Hemodiafiltration in developing countries

Kusirisin

Srisawat

2022

Seminars in Dialysis

View full text Add to dashboard Cite

Hemodiafiltration (HDF) is a promising kidney replacement therapy modality for patients with end‐stage kidney disease. The principle of uremic toxin clearance by combining convection and diffusion can lead to greater benefits compared to conventional hemodialysis. Evidence is building that supports the advantages of HDF with short‐term outcomes such as greater intradialytic hemodynamic stability, improved nutritional status, attenuation of anemia, and reduction of inflammatory cytokines which produce improved key long‐term impacts including survival and cardiovascular outcomes. Very little is known about the prevalence of HDF treatments in developing countries due to a shortage of national kidney registries. HDF experience is limited in many countries due to the cost of dialysis treatments, availability of online HDF machines, and reimbursement policies. These obstacles have led to nephrologists developing innovations, for example, convective control HDF (CC‐HDF), simple mid‐dilution, and simple mixed‐dilution methods, which may be as effective as commercially available HDF machines. In this article, we will focus on the experience of HDF practice and barriers to adoption in developing countries. Results can guide clinical practice recommendations for implementing HDF in resource‐limited settings.

show abstract

“…In the case of pre-dialysis KT candidates, SA-specific eGFR equations can be explored[ 41 ]. Among dialysis modalities, peritoneal dialysis may decrease post-transplant graft dysfunction[ 42 ]. In all cases, SA candidates require special attention to pre-transplant cardiovascular risk reduction to optimize post-transplant success.…”

Section: Cardiovascular Disease Screeningmentioning

confidence: 99%

Managing cardiovascular disease risk in South Asian kidney transplant recipients

Prasad¹,

Bhamidi²

2021

WJT

View full text Add to dashboard Cite

South Asians (SA) are at higher cardiovascular risk than other ethnic groups, and SA kidney transplant recipients (SA KTR) are no exception. SA KTR experience increased major adverse cardiovascular events both early and late post-transplantation. Cardiovascular risk management should therefore begin well before transplantation. SA candidates may require aggressive screening for pre-transplant cardiovascular disease (CVD) due to their ethnicity and comorbidities. Recording SA ethnicity during the pre-transplant evaluation may enable programs to better assess cardiovascular risk, thus allowing for earlier targeted peri- and post-transplant intervention to improve cardiovascular outcomes. Diabetes remains the most prominent post-transplant cardiovascular risk factor in SA KTR. Diabetes also clusters with other metabolic syndrome components including lower high-density lipoprotein cholesterol, higher triglycerides, hypertension, and central obesity in this population. Dyslipidemia, metabolic syndrome, and obesity are all significant CVD risk factors in SA KTR, and contribute to increased insulin resistance. Novel biomarkers such as adiponectin, apolipoprotein B, and lipoprotein (a) may be especially important to study in SA KTR. Focused interventions to improve health behaviors involving diet and exercise may especially benefit SA KTR. However, there are few interventional clinical trials specific to the SA population, and none are specific to SA KTR. In all cases, understanding the nuances of managing SA KTR as a distinct post-transplant group, while still screening for and managing each CVD risk factor individually in all patients may help improve the long-term success of all kidney transplant programs catering to multi-ethnic populations.

show abstract

What Is the Best Dialysis Therapy for South Asia: HD or PD?

Cited by 4 publications

References 13 publications

“Why I Chose Hemodialysis over Peritoneal Dialysis”: An Opinion Survey among In-Center Hemodialysis Patients

“Why I Chose Hemodialysis over Peritoneal Dialysis”: An Opinion Survey among In-Center Hemodialysis Patients

Hemodiafiltration in developing countries

Managing cardiovascular disease risk in South Asian kidney transplant recipients

Contact Info

Product

Resources

About