Options of Renal Replacement Therapy in CKDu

Area of Science:

• Nephrology
• Public Health

Background:

• Advanced Chronic Kidney Disease of Unknown origin (CKDu) necessitates renal replacement therapy (RRT).
• Living-related renal transplantation is often the preferred RRT, but potential donors may be at risk for CKDu.
• Hemodialysis (HD) centers are typically urban, posing access challenges for rural CKDu patients.

Purpose of the Study:

• To explore optimal RRT strategies for CKDu patients.
• To highlight initiatives addressing RRT accessibility for CKDu.
• To propose a public-private partnership model for comprehensive CKDu care.

Main Methods:

• Review of RRT options including transplantation and dialysis.
• Case study of Sri Lanka's "PD first" pilot project.
• Examination of India's Aarogyasri insurance scheme for CKDu patients.

Main Results:

• Peritoneal dialysis (PD) offers a convenient home-based RRT option for CKDu patients.
• Sri Lanka's "PD first" project successfully trains community physicians for PD delivery.
• Aarogyasri scheme facilitates free HD and transplantation for impoverished CKDu patients.

Conclusions:

• PD is a viable and accessible RRT for CKDu patients, especially in resource-limited settings.
• Public-private partnerships are crucial for ensuring accessible and comprehensive RRT for all CKDu-affected individuals.
• Addressing financial and social barriers is essential for equitable CKDu management.