Nephrology in South East Asia: fact and concept

The developing countries of South East Asia lie within the tropics. Renal disease in this region represents the interaction between the kidney and the environment abetted by low levels of socioeconomic development in many areas. Together with genetic susceptibility to some diseases, there are widespread infectious diseases and prominently encountered plant and animal toxins. Chronic renal failure, most commonly the outcome of chronic glomerulonephritis and frequently to persistent nephrolithiasis as well as acute renal failure due to a variety of stimuli, are among the most common renal problems encountered. Renal replacement therapy is both a clinical and economic problem. The epidemiology of renal disease in the region is poorly understood, and workforce and treatment facilities are not adequate for the caseload in a number of countries in the region. Many people with chronic renal disease simply cannot afford the necessary treatment. The principle focus for the future must be on prevention strategies and the provision of appropriate health services within the current economic and technological restraints.