Catalyzing peritoneal dialysis growth in Brunei: The crucial role of governmental support

Brunei Darussalam, a small Southeast Asian nation, faces a unique healthcare challenge with one of the world's highest incidence and prevalence of kidney replacement therapy. This report highlights the remarkable success of Brunei in increasing the utilization of peritoneal dialysis (PD) to address this challenge. As of August 2023, Brunei's PD penetrance rate stands at 16%, a significant leap from 9.7% just three years ago. This is comparable to many other high-income countries. The key to this success lies in a series of governmental support strategies that fostered rapid PD growth. These strategies include the establishment of a dedicated task force, securing dedicated operating theater slots, collaboration with surgery and anesthesia departments, nephrologist training, a dedicated surgeon for complex cases, outsourcing to private hospitals, prioritizing nursing staff, structured patient training programs, patient advocacy and established clinical protocols. These collaborative efforts, along with a patient-centric approach, have not only reduced PD catheter insertion waiting times but also empowered patients to voice their preferences in shared decisions. Brunei's journey serves as an inspiring example for other nations seeking to proliferate their PD services.