Peritoneal Dialysis in Asia.

Area of Science:

• Nephrology
• Public Health
• Health Economics

Background:

• Asia faces a rising demand for dialysis due to end-stage renal failure, with diabetes mellitus as a primary cause.
• The prevalence of end-stage renal failure is increasing across both developed and developing regions in Asia.

Purpose of the Study:

• To evaluate the trends, clinical outcomes, and socio-economic benefits of peritoneal dialysis (PD) compared to hemodialysis (HD) in Asia.
• To explore the potential of a 'PD-first' policy to manage the growing burden of renal failure in Asian countries.

Main Methods:

• Comparative analysis of clinical outcomes and cost-effectiveness between PD and HD.
• Review of global and regional trends in dialysis modality adoption and patient management.
• Examination of factors influencing PD penetration, including reimbursement policies and patient/practitioner education.

Main Results:

• Peritoneal dialysis (PD) shows significant growth and improved quality of care in Asia, with outcomes comparable to hemodialysis (HD).
• PD is generally more cost-effective than HD in most Asian countries, offering socio-economic benefits, particularly for urban and rural populations.
• Global reduction in peritonitis rates is observed, though specific challenges like tuberculosis infections persist in some South Asian regions.

Conclusions:

• A 'PD-first' policy is a viable strategy for managing renal failure in Asia, leveraging PD's cost-effectiveness and comparable outcomes to HD.
• Enhanced PD practices and targeted initiatives to reduce costs are crucial for addressing the increasing dialysis demand.
• Addressing practitioner education and patient information gaps is essential to increase PD utilization across Asia and globally.