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Peritoneal dialysis in Asia

I K Cheng1

  • 1Department of Medicine, University of Hong Kong, Queen Mary and Tung Wah Hospital, Hong Kong.

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|January 1, 1996
PubMed
Summary

Government reimbursement policies and socioeconomic status significantly impact end-stage renal disease (ESRD) treatment choices in Asia. Peritoneal dialysis (PD) utilization shows a biphasic relationship with GDP, with growth expected to favor PD over hemodialysis (HD).

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Area of Science:

  • Nephrology
  • Public Health
  • Health Economics

Background:

  • Socioeconomic status and government reimbursement policies vary widely across Asian countries.
  • These factors significantly influence treatment choices for end-stage renal disease (ESRD).
  • Peritoneal dialysis (PD) utilization in Asia is influenced by these diverse healthcare landscapes.

Purpose of the Study:

  • To analyze the relationship between socioeconomic factors, government reimbursement, and ESRD treatment modalities in Asia.
  • To investigate the utilization rates of peritoneal dialysis (PD) and its various systems across different Asian countries.
  • To examine trends in PD versus hemodialysis (HD) and the adoption of different PD techniques.

Main Methods:

  • Data collected from 11 representative Asian countries.
  • Analysis of correlations between Gross Domestic Product (GDP) per capita income and ESRD treatment rates.
  • Comparative analysis of PD utilization rates, PD system preferences, and dialysis prescription patterns.

Main Results:

  • ESRD treatment rates strongly correlate with GDP per capita income.
  • PD utilization exhibits a biphasic relationship with GDP and treatment rates, being lower at extremes and higher at moderate levels.
  • While conventional and UV germicidal systems are still used, there's a progressive shift towards disconnect systems for PD, especially in newer markets like China and India. PD growth outpaces HD in most surveyed countries.
  • Low calcium dialysate use is limited, and average daily CAPD exchanges vary, with lower numbers debated but showing acceptable outcomes.

Conclusions:

  • Healthcare policies and economic status are key determinants of ESRD treatment and PD adoption in Asia.
  • The trend towards disconnect PD systems is likely to continue, driven by cost-effectiveness data.
  • Further research on dialysis adequacy across different ethnic groups is needed to refine treatment guidelines for Asian populations.

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