Peritoneal dialysis in Asia: an external perspective

Area of Science:

• Nephrology
• Public Health

Background:

• Peritoneal dialysis (PD) is utilized by nearly 30,000 patients in Asia, comprising 8% of the region's dialysis population.
• PD penetration varies significantly across Asian countries, with Hong Kong, Korea, and Singapore showing the highest rates.

Purpose of the Study:

• To review the varying rates of PD use in Asia and identify contributing factors, including the influence of public versus private dialysis providers.
• To examine patient and technique survival rates in Asian countries and compare them with Asian patients in North America.
• To analyze the relationship between dialysis clearance, ultrafiltration, and clinical outcomes in the Asian context.

Main Methods:

• Review of existing data on PD patient numbers, penetration rates, and survival statistics across various Asian countries.
• Comparative analysis of PD outcomes between Asian patients in Asia and Asian patients residing in North America.
• Examination of treatment approaches, including clearance and ultrafiltration strategies, in Asian dialysis centers.

Main Results:

• Dialysis provider models (public vs. private) significantly influence PD utilization rates.
• Asian patients in North America demonstrate superior survival and PD compliance compared to Caucasian patients.
• Lower baseline health status in Western populations may explain the more pronounced benefits of aggressive dialysis clearance compared to Asian populations.

Conclusions:

• The healthier baseline health status of South East Asian patients contributes to their favorable PD outcomes.
• Less aggressive clearance and ultrafiltration strategies are employed in Asian countries.
• The Hong Kong model of dialysis delivery, with its high PD utilization, presents unique advantages and disadvantages that warrant further review.