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Hyodo T, Yamashita AC, Hirawa N, Isaka Y, Nakamoto H, Shigematsu T. Present status of renal replacement therapy in lower-middle-income Asian countries: Cambodia, Myanmar, Laos, Vietnam, Mongolia, and Bhutan as of June 2019 (before COVID-19), from the interviews of leading doctors in every country: (duplicated English publication from “the special Japanese edition of educational lectures in the 64th annual meeting of the Japanese Society for Dialysis Therapy”). RENAL REPLACEMENT THERAPY 2022; 8:54. [PMID: 36277446 PMCID: PMC9579646 DOI: 10.1186/s41100-022-00443-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/28/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractThe present status of Cambodia, Myanmar, Laos, Vietnam, Mongolia, and Bhutan as of June 2019 was reviewed from the interviews of leading doctors in every country. The timing was until just 6 months before the COVID-19 pandemic broke out. The cost per hemodialysis session was 25–70 US dollar and expensive if it is compared with average monthly income of every country. In Cambodia and Laos, patients must cover 100% of expenses for maintenance hemodialysis, in Myanmar, the government covers the cost of once-weekly dialysis sessions, in Vietnam, the government covers 80% of the cost, and in Mongolia and Bhutan, the cost is fully covered by the government. Continuous ambulatory peritoneal dialysis was widely available in Vietnam and Mongolia, which have achieved a relative standard of social infrastructure, but is far from common in any of the other countries. The number of patients on dialysis is increasing with economic development in all countries. Diabetic nephropathy is a common primary reason for dialysis. None of the countries discussed in this article had clinical engineers who could maintain hemodialysis equipment and carry out clinical tasks in dialysis centers. Hospitals were not maintaining their equipment, and damaged units were kept in storage to be used for spare parts. None of the countries had dieticians to provide patients with dietary guidance. Establishment and training of both clinical engineers and registered dietitians are major projects that must be undertaken.
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Bodhisane S, Pongpanich S. The influence of the National Health Insurance scheme of the Lao People's Democratic Republic on healthcare access and catastrophic health expenditures for patients with chronic renal disease, and the possibility of integrating organ transplantation into the health financing system. Health Res Policy Syst 2022; 20:71. [PMID: 35725620 PMCID: PMC9207827 DOI: 10.1186/s12961-022-00869-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
Citizens of the Lao People’s Democratic Republic have difficulties in obtaining proper health services compared to more developed countries, due to the lack of available health facilities and health financing programmes. Haemodialysis (HD) is currently included under the coverage of the National Health Insurance (NHI) scheme. However, there are several technical barriers related to health service utilization. This study aims to analyse the effects of the Lao NHI on issues of accessibility and the possibility of encountering catastrophic health expenditures for patients with chronic kidney disease. In addition, the study provides policy recommendations for policy-makers regarding the provision of organ transplantation under NHI in the future. Savannakhet Province was purposively selected as a study site, where 342 respondents participated in the study. Two logistic regression models are used to assess the effectiveness of the NHI in terms of accessibility and financial protection against catastrophic health expenditures. The Andersen behavioural model is applied as a guideline to identify factors that affect accessibility and economic catastrophe. NHI is found to improve accessibility to health service utilization for household members with chronic kidney disease. However, due to the limited HD services, there are barriers to accessing health services and a risk of financial hardship due to nonmedical expenditures. Chronic conditions, in addition to kidney issues, dramatically increase the chances of suffering catastrophic health expenditures. In the short run, collaboration with neighbouring countries’ hospitals through copayment programmes is strongly recommended for NHI’s policy-makers. For long-term policy guidelines, the government should move forward to include kidney transplantation in the NHI healthcare system.
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Affiliation(s)
- Somdeth Bodhisane
- College of Public Health Science (CPHS), Chulalongkorn University, Bangkok, Thailand.
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Tan J, Liew A, Koh D. Clinical outcomes and performance indicators of patients with Kidney Failure and Acute Kidney Injuries in ASEAN countries. Nephrology (Carlton) 2022; 27:739-752. [PMID: 35661340 DOI: 10.1111/nep.14070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/29/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This review article reports clinical outcomes and performance indicators of patients with Kidney Failure (KF) and Acute Kidney Injuries (AKI) in Association of South East Asian Nations (ASEAN) countries. METHODOLOGY ASEAN data, segregated by income status, from national registries and literature were collated, compared and benchmarked against international references. RESULTS The national incidence and prevalence of treated KF ranged from 172-479 per million population (pmp) and 36-2255 pmp respectively. Brunei (79%), Malaysia (66%) and Singapore (66%) had world-leading proportions of diabetes-related KF. Haemodialysis (HD), Peritoneal Dialysis (PD) and transplant accounted for 68-100%, 0-27% and 0-18% of all Kidney Failure Replacement Therapy respectively. Transplant patient survival were superior with 90-93% at five years and 71-90% at 10 years, compared to PD (44-54%) and HD (53-64%) at five years. Higher-income countries were able to achieve good anaemia control, HD and PD adequacy targets, whilst usage of arteriovenous fistula in HD varied from 70-85%. Acute Kidney Injury (AKI) rates ranged from 24.2-49.2% of high-dependency admissions. Lower incidences of PD peritonitis and HD Catheter-related Bloodstream Infections; and PD-favouring quality-of-life were evident in higher-income countries. CONCLUSION ASEAN has a challenging burden of kidney disease, with extremely high incidence, prevalence, DM-related KF and AKI rates. The magnitude of the prevailing problem calls for the creation of a regional society under the auspices of ASEAN with a shared perspective of universal, equitable and charitable access to quality renal care; consistent with the founding premises and healthcare initiatives of ASEAN. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jackson Tan
- Department of Nephrology, Ripas Hospital / Universiti Brunei Darussalam, Brunei Darussalam
| | - Adrian Liew
- The Kidney & Transplant Practice, Mount Elizabeth Novena Hospital, Singapore
| | - David Koh
- NUS Saw Swee Hock School of Public Health, Singapore
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Hyodo T, Hirawa N, Isaka Y, Nakamoto H, Thim P, Phon E, Hy C, Chan S, Kokubo K, Matsubara H, Wakai H, Yamashita AC, Kawanishi H. Current status of renal replacement therapy in Cambodia and Japanese support activities in developing countries in East and Southeast Asia: a report as of June 2018 from the Non-Western World Countries Symposium at the 63rd Annual Meeting of the Japanese Society for Dialysis Therapy. RENAL REPLACEMENT THERAPY 2022. [DOI: 10.1186/s41100-022-00398-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractSince 2015, the Committee of International Communication for Academic Research of the Japanese Society for Dialysis Therapy has held a symposium every year at the society’s Annual Congress to discuss the current status of and demand for dialysis therapy in developing countries in Asia with the aim of identifying ways to contribute to the field of dialysis therapy in these countries. The 2018 symposium opened the door further, beyond Asian countries to include all non-Western countries. Two speakers from Cambodia and Japan contributed their manuscripts to the 2018 symposium issue. In Cambodia in 2017, a study of hemodialysis data from 5 centers in Phnom Penh was conducted for the first time. This study involving 407 patients (233 men [57.2%]; mean age 52 [SD, ± 15] years) revealed that hypertension was the main cause of end-stage renal disease (46.8%), followed by concomitant hypertension and diabetes mellitus (31%), with diabetes mellitus alone accounting for only 8.1% of cases. Mean frequency of hemodialysis was 7.5 (SD, ± 2.3) sessions per month. The duration of each session was 4 h. Patients in Cambodia are required to bear the full cost for hemodialysis because the country lacks a national health insurance system. From 2007 to 2018, several Japanese societies and organizations for dialysis therapy and technology carried out activities aimed at resolving problems in dialysis medical care in developing countries in East and Southeast Asia. The role of the academic societies and their activities in this region are discussed.
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Chen JHC, Brown MA, Jose M, Brennan F, Johnson DW, Roberts MA, Wong G, Cheikh Hassan H, Kennard A, Walker R, Davies CE, Boudville N, Borlace M, Hawley C, Lim WH. Temporal changes and risk factors for death from early withdrawal within 12 months of dialysis initiation-a cohort study. Nephrol Dial Transplant 2022; 37:760-769. [PMID: 34175956 PMCID: PMC8951200 DOI: 10.1093/ndt/gfab207] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Mortality risk is high soon after dialysis initiation in patients with kidney failure, and dialysis withdrawal is a major cause of early mortality, attributed to psychosocial or medical reasons. The temporal trends and risk factors associated with cause-specific early dialysis withdrawal within 12 months of dialysis initiation remain uncertain. METHODS Using data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the temporal trends and risk factors associated with mortality attributed to early psychosocial and medical withdrawals in incident adult dialysis patients in Australia between 2005 and 2018 using adjusted competing risk analyses. RESULTS Of 32 274 incident dialysis patients, 3390 (11%) experienced death within 12 months post-dialysis initiation. Of these, 1225 (36%) were attributed to dialysis withdrawal, with 484 (14%) psychosocial withdrawals and 741 (22%) medical withdrawals. These patterns remained unchanged over the past two decades. Factors associated with increased risk of death from early psychosocial and medical withdrawals were older age, dialysis via central venous catheter, late referral and the presence of cerebrovascular disease; obesity and Asian ethnicity were associated with decreased risk. Risk factors associated with early psychosocial withdrawals were underweight and higher socioeconomic status. Presence of peripheral vascular disease, chronic lung disease and cancers were associated with early medical withdrawals. CONCLUSIONS Death from dialysis withdrawal accounted for >30% of early deaths in kidney failure patients initiated on dialysis and remained unchanged over the past two decades. Several shared risk factors were observed between mortality attributed to early psychosocial and medical withdrawals.
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Affiliation(s)
- Jenny H C Chen
- School of Medicine, University of Wollongong, Wollongong, Australia
- Depatment of Renal Medicine, Wollongong Hospital, Wollongong, Australia
| | - Mark A Brown
- Department of Nephrology, St George Hospital, Sydney, Australia
- School of Medicine, University of New South Wales, Sydney, Australia
| | - Matthew Jose
- School of Medicine, The University of Tasmania, Hobart, Australia
- Department of Nephrology, Royal Hobart Hospital, Hobart, Australia
| | - Frank Brennan
- Department of Nephrology, St George Hospital, Sydney, Australia
- School of Medicine, University of New South Wales, Sydney, Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Health Services Research, University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
- Australasian Kidney Trials Network, Brisbane, Australia
| | - Matthew A Roberts
- School of Medicine, Monash University, Melbourne, Australia
- Renal Service, Eastern Health, Melbourne, Australia
| | - Germaine Wong
- Sydney School of Public Health, University of Sydney, Sydney, Australia
- Centre for Kidney Research, The Children’s Hospital at Westmead, Westmead, Australia
- Centre for Transplant and Renal Research, Westmead Hospital, Westmead, Australia
| | - Hicham Cheikh Hassan
- School of Medicine, University of Wollongong, Wollongong, Australia
- Depatment of Renal Medicine, Wollongong Hospital, Wollongong, Australia
| | - Alice Kennard
- School of Medicine, Australian National University, Canberra, Australia
- Department of Nephrology, Canberra Hospital, Canberra, Australia
| | - Rachael Walker
- Sydney School of Public Health, University of Sydney, Sydney, Australia
- School of Nursing, Eastern Institute of Technology, Napier, New Zealand
| | - Christopher E Davies
- Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Neil Boudville
- Medical School, University of Western Australia, Perth, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Monique Borlace
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, Australia
| | - Carmel Hawley
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Health Services Research, University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
- Australasian Kidney Trials Network, Brisbane, Australia
| | - Wai H Lim
- Medical School, University of Western Australia, Perth, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
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Missing In-Center Hemodialysis Sessions among Patients with End Stage Renal Disease in Banda Aceh, Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179215. [PMID: 34501804 PMCID: PMC8431045 DOI: 10.3390/ijerph18179215] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/04/2021] [Accepted: 08/28/2021] [Indexed: 01/13/2023]
Abstract
Indonesian universal health coverage was implemented in 2013 and hemodialysis services became universally accessible, yet few studies have examined patient adherence to hemodialysis schedules. We examined the rates of missed in-center hemodialysis sessions in Banda Aceh and the factors associated with non-attendance. This cross-sectional questionnaire survey included 193 patients receiving in-center hemodialysis. Approximately 28% of the patients missed ≥ 1 hemodialysis session in the month prior to the questionnaire’s administration. About 65% reported attending religious activities as the reason for missing hemodialysis. The level of health literacy was generally low with a mean score of 14.38 out of 26 (55.3%). Multivariate logistic regression analyses showed that patients with educational levels higher than elementary school were less likely to miss hemodialysis sessions. Participants who performed more self-care behaviors had lower odds of missing hemodialysis sessions. Every unit increase in the health literacy score was associated with increased odds of missing hemodialysis sessions. Emphasizing the importance of attending hemodialysis sessions and modifying hemodialysis schedules based on patients’ needs is essential. Patients who miss hemodialysis sessions should be reminded of all self-care behaviors. Health literacy among hemodialysis patients should be improved, with emphasis on patient safety, advanced knowledge, and critical health literacy.
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Jonny, Violetta L, Kusumaningrum VF. Peritoneal dialysis in Indonesia: Current status, challenges and prospects. Perit Dial Int 2021; 42:428-433. [PMID: 34338050 DOI: 10.1177/08968608211034985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite an increase in incident peritoneal dialysis (PD) use of 20% per year, the overall PD prevalence in Indonesia is only 1-2%, with the goal of 30% yet to be reached by 2019. In the absence of contraindications, increasing continuous ambulatory PD (CAPD) use may be an attractive option for Indonesia to reduce the high costs of end-stage kidney disease (ESKD) treatment. The implementation of CAPD in Indonesia faces several challenges, including the cost of PD, the unique archipelagic geography, limited facilities and trained medical personnel in rural areas, inadequate reimbursement rates and incentive fees, high rates of PD discontinuation, as well as insufficient knowledge regarding CAPD by the general public and health professionals. Changes in the policy of medical service incentive fees and improvements in the national health insurance system regulation over CAPD may improve the utilization of PD for ESKD patients in Indonesia. Nationwide promotional and preventive efforts on chronic kidney disease, dialysis modality education and establishment of PD training programs for medical professionals are necessary.
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Affiliation(s)
- Jonny
- Department of Internal Medicine, Nephrology Division, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia
| | - Laurencia Violetta
- Department of Internal Medicine, Nephrology Division, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia
| | - Venna Febrian Kusumaningrum
- Department of Internal Medicine, Nephrology Division, Gatot Soebroto Indonesia Army Central Hospital, Jakarta, Indonesia
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Ethier I, Johnson DW, Bello AK, Ye F, Osman MA, Levin A, Harris DCH, Kerr P, Liew A, Wong MG, Lunney M, Saad S, Zaidi D, Khan M, Jha V, Tonelli M, Okpechi IG, Viecelli AK. International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Oceania and South East Asia. Kidney Int Suppl (2011) 2021; 11:e86-e96. [PMID: 33981474 DOI: 10.1016/j.kisu.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/09/2020] [Accepted: 01/06/2021] [Indexed: 10/21/2022] Open
Abstract
Oceania and South East Asia (OSEA) is a socioeconomically, culturally, and ethnically diverse region facing a rising epidemic of noncommunicable diseases, including chronic kidney disease (CKD). The second iteration of the International Society of Nephrology Global Kidney Health Atlas aimed to provide a comprehensive evaluation of kidney care in OSEA. Of the 30 countries/territories in OSEA, 15 participated in the survey, representing 98.5% of the region's population. The median prevalence of treated kidney failure in OSEA was 1352 per million population (interquartile range, 966-1673 per million population), higher than the global median of 787 per million population. Although the general availability, access, and quality of kidney replacement therapy (i.e., dialysis and transplantation) was high in OSEA, inequalities in accessibility and affordability of kidney replacement therapy across the region resulted in variability between countries. According to the survey results, in a third of the participating countries (mostly lower-income countries), less than half the patients with kidney failure were able to access dialysis, whereas it was readily available to all with minimal out-of-pocket costs in high-income countries; similar variability in access to transplantation was also recorded. Limitations in workforce and resources vary across the region and were disproportionately worse in lower-income countries. There was little advocacy for kidney disease, moderate use of registries, restricted CKD detection programs, and limited availability of routine CKD testing in some high-risk groups across the region. International collaborations, as seen in OSEA, are important initiatives to help close the gaps in CKD care provision across the region and should continue receiving support from the global nephrology community.
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Affiliation(s)
- Isabelle Ethier
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Division of Nephrology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
| | - David W Johnson
- Department of Nephrology, Metro South and Ipswich Nephrology and Transplant Services, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Centre for Kidney Disease Research, University of Queensland at Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Translation Research Institute, Brisbane, Queensland, Australia
| | - Aminu K Bello
- Division of Nephrology and Immunology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Feng Ye
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Mohamed A Osman
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Adeera Levin
- Division of Nephrology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - David C H Harris
- Centre for Transplantation and Renal Research, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia
| | - Peter Kerr
- Nephrology, Monash Medical Centre, Victoria, Australia
| | - Adrian Liew
- The Kidney & Transplant Practice, Mount Elizabeth Novena Hospital, Singapore
| | - Muh Geot Wong
- Department of Renal Medicine, Royal North Shore Hospital, University of Sydney, New South Wales, Australia.,The George Institute for Global Health, Sydney, Australia
| | - Meaghan Lunney
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Syed Saad
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Deenaz Zaidi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Khan
- Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - Vivekanand Jha
- George Institute for Global Health, University of New South Wales, New Delhi, India.,School of Public Health, Imperial College, London, UK.,Manipal Academy of Higher Education, Manipal, India
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada.,Pan-American Health Organization/World Health Organization's Collaborating Centre in Prevention and Control of Chronic Kidney Disease, University of Calgary, Calgary, Alberta, Canada
| | - Ikechi G Okpechi
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.,Division of Nephrology and Hypertension, University of Cape Town, Cape Town, South Africa.,Kidney and Hypertension Research Unit, University of Cape Town, Cape Town, South Africa
| | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Centre for Kidney Disease Research, University of Queensland, Brisbane, Queensland, Australia
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Sahay M, Jasuja S, Wai TSC, Alexander S, Jha V, Vachharajani T, Mostafi M, Pisharam JK, Jacob C, Gunawan A, Leong GB, Thwin KT, Agrawal RK, Vareesangthip K, Tanchanco R, Choong L, Herath C, Lin CC, Cuong NT, Haian HP, Akhtar SF, Alsahow A, Rana DS, Rajapurkar MM, Kher V, Verma S, Ramachandran R, Bhargava V, Puri S, Sagar G, Bahl A, Mandal S, Gupta A, Gallieni M. Aetiology, practice patterns and burden of end-stage kidney disease in South Asia and South-East Asia: A questionnaire-based survey. Nephrology (Carlton) 2021; 26:142-152. [PMID: 33169890 PMCID: PMC7615902 DOI: 10.1111/nep.13825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/11/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022]
Abstract
AIM There is paucity of data on the epidemiology of end-stage kidney disease (ESKD) from South Asia and South-East Asia. The objective of this study was to assess the aetiology, practice patterns and disease burden and growth of ESKD in the region comparing the economies. METHODS The national nephrology societies of the region; responded to the questionnaire; based on latest registries, acceptable community-based studies and society perceptions. The countries in the region were classified into Group 1 (High|higher-middle-income) and Group 2 (lower|lowermiddle income). Student t-test, Mann-Whitney U test and Fisher's exact test were used for comparison. RESULTS Fifteen countries provided the data. The average incidence of ESKD was estimated at 226.7 per million population (pmp), (Group 1 vs. Group 2, 305.8 vs. 167.8 pmp) and average prevalence at 940.8 pmp (Group 1 vs. Group 2, 1306 vs. 321 pmp). Group 1 countries had a higher incidence and prevalence of ESKD. Diabetes, hypertension and chronic glomerulonephritis were most common causes. The mean age in Group 2 was lower by a decade (Group 1 vs. Group 2-59.45 vs 47.7 years). CONCLUSION Haemodialysis was the most common kidney replacement therapy in both groups and conservative management of ESKD was the second commonest available treatment option within Group 2. The disease burden was expected to grow >20% in 50% of Group 1 countries and 78% of Group 2 countries along with the parallel growth in haemodialysis and peritoneal dialysis.
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Affiliation(s)
- Manisha Sahay
- Department of Nephrology Osmania General Hospital, Hyderabad (+91) 9849097507
| | - Sanjiv Jasuja
- Department of Nephrology Indraprastha Apollo Hospital, Delhi (+91) 9711197981
| | - Tang Sydeny Chi Wai
- Department of Nephrology Queen Mary Hospital Hong Kong Society of Nephrology (+852) 92360037
| | | | - Vivekanand Jha
- Department of Nephrology George Institute of Global Health (+91) 85275 44733
| | - Tushar Vachharajani
- Department of Nephrology Cleveland Clinic, Ohio, United States (+1) 336 546 2713
| | - Mamun Mostafi
- Department of Nephrology Armed Forces Medical College, Bangladesh Representative from Bangladesh Renal Association (+880) 171 3035 346
| | - Jayakrishnan K Pisharam
- Department of Nephrology Ministry of Health, Brunei, Darussalam Medical Services, Brunei Representative from Brunei Society of Nephrology (+673) 817 8123
| | - Chakko Jacob
- Department of Nephrology Bangalore Baptist Hospital, India Representative from Indian Society of Nephrology (+91)9535236019
| | - Atma Gunawan
- Department of Nephrology Brawijaya University, Indonesia Representative from Society of Nephrology Indonesia (+62) 812 3300 543
| | - Goh Bak Leong
- Department of Nephrology Serdang Hospital, Malaysia Representative from Malaysian Nephrology Congress (+60) 1260 69119
| | - Khin Thida Thwin
- Department of Nephrology University Of Medicine, Myanmar Representative from Myanmar Nephro-Uro Society (+95) 95021764
| | - Rajendra Kumar Agrawal
- Department of Nephrology Bir Hospital, Nepal Nepal Society of Nephrology (+977)98 5102 3840
| | - Kriengsak Vareesangthip
- Department of Nephrology Siriraj Hospital, Mahidol University, Thailand Representative from Nephrology Society of Thailand (+66) 24198383
| | - Roberto Tanchanco
- Department of Nephrology The Medical City, Philippine Representative from Philippine Society of Nephrology (+63)9189173940
| | - Lina Choong
- Department of Nephrology Singapore General Hospital, Singapore Representative from Singapore Society of Nephrology (+65) 81253594
| | - Chula Herath
- Department of Nephrology Sri Jayewardenepura General Hospital, Srilanka Representative from Sri Lanka Society of Nephrology (+94) 773017025
| | - Chih-Ching Lin
- Department of Nephrology Taipei Veterans General Hospital, Taiwan Representative from Taiwan society of Nephrology (+886) 937024083
| | - Nguyen The Cuong
- Department of Nephrology Hochiminh City national University, Vietnam Representative from Society of Nephrology-Urology of Vietnam (+84) 912 323276
| | - Ha Phan Haian
- Department of Nephrology Viet Duc University Hospital, Vietnam Representative from- Society of Nephrology-Urology of Vietnam (+84) 913546992
| | - Syed Fazal Akhtar
- Department of Nephrology Sindh Institute of Urology and Transplantation, Pakistan Representative from Pakistan Society of Nephrology (+92)300 8249856
| | - Ali Alsahow
- Department of Nephrology Jahara Hospital, Kuwait Representative From Gulf Corporation Council (+96)599335599
| | - D S Rana
- Department of Nephrology Sir Gangaram Hospital, Delhi (+91)9811033984
| | - M M Rajapurkar
- Department of Nephrology Muljibhai Patel Urological Hospital, Gujrat (+91) 9824349500
| | - Vijay Kher
- Department of Nephrology Medanta Hospital Gurugram, Haryana (+91) 9811054118)
| | - Shalini Verma
- Clinical Research AVATAR foundation, New Delhi (+91)8586983027
| | | | - Vinant Bhargava
- Department of Nephrology Sir Ganga Ram Hospital, Delhi (+91) 9990610096
| | - Sonika Puri
- Department of Nephrology Rutgers Robert Wood Johnson Medical School, New Jersy United States +1 (732) 501 1737
| | - Gaurav Sagar
- Department of Nephrology Indraprastha Apollo Hospital, Delhi (+91) 9810995996
| | - Anupam Bahl
- Department of Nephrology Indraprastha Apollo Hospital, Delhi (+91) 9711311750
| | - Sandeep Mandal
- Department of Nephrology Columbia Asia Hospital, Gurugram (+91) 8130007368
| | - Ashwani Gupta
- Department of Nephrology Sir Ganga Ram Hospital, Delhi (+91) 9811049761
| | - Maurizio Gallieni
- Department of Nephrology ‘L. Sacco’ Department of Biomedical and Clinical Sciences University of Milano, Italy (+39) 347746 8832
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Hyodo T, Fukagawa M, Hirawa N, Isaka Y, Nakamoto H, Van Bui P, Thwin KT, Hy C. Present status of renal replacement therapy in Asian countries as of 2017: Vietnam, Myanmar, and Cambodia. RENAL REPLACEMENT THERAPY 2020. [DOI: 10.1186/s41100-020-00312-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractSince 2015, the Committee of International Communication on Academic Research of the Japanese Society for Dialysis Therapy has held its Asian symposium during the society’s Annual Congress to discuss the present status of and demand for dialysis therapy in Asian countries. The aim of the symposium is to identify needs and find ways to contribute in the area of dialysis therapy in these countries. Three manuscripts are presented here by participants at the 2017 Asian symposium from Vietnam, Myanmar, and Cambodia.With economic development, hemodialysis (HD) therapy is now available worldwide. However, the cost of HD is very high compared with the average income in these three countries and, as of 2017, Cambodia and Myanmar have not yet established national health insurance systems. In Cambodia, patients must bear 100% of the cost for dialysis. In Myanmar, the government covers the cost of HD (20 USD, 40% of total cost) in public HD centers, but this service is still insufficient to meet current demand, with long waiting lists of up to 6 months at government HD centers. In contrast, in Vietnam, dialysis is almost completely covered by national health insurance. Dialyzers tend to be reused in all three countries. Continuous ambulatory peritoneal dialysis is available in Vietnam and Myanmar but not in Cambodia. Viable health insurance systems should be established as soon as possible in Cambodia and Myanmar, although this will ultimately depend on the countries’ level of economic development.
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Ambarsari CG, Hidayati EL, Trihono PP, Saraswati M, Rodjani A, Wahyudi I, Situmorang GR, Kim JJ, Mellyana O, Kadaristiana A. Experience of the first 6 years of pediatric kidney transplantation in Indonesia: A multicenter retrospective study. Pediatr Transplant 2020; 24:e13812. [PMID: 32794281 DOI: 10.1111/petr.13812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 06/11/2020] [Accepted: 07/15/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Pediatric kidney transplantation was only introduced in Indonesia in 2013. We therefore aimed to assess the characteristics and outcomes of transplants performed from its inception to January 2019. METHOD The study had a dual-center retrospective design. We examined the records of kidney transplant recipients and then calculated patient and graft survival rates by Kaplan-Meier survival analysis with 95% confidence intervals (95% CI). RESULTS In total, 12 kidney transplantations were performed in eleven children during the study period; among these, ten were boys, and nine had renal failure caused by congenital anomaly of the kidney or urinary tract. All donors were living, and all recipients were on dialysis at the time of transplantation, when their median age was 14.5 years (range, 8-19 years). Three patients died of infection in the first year of follow-up and two lost their allograft by the time of their last follow-up (median, 13 months; range, 4-69 months). The 1-year patient survival rate was therefore 68.18% (95% CI, 29.72%-88.61%), which remained unchanged at 3 and 5 years. However, the non-death-censored graft survival rates at 1, 3, and 5 years were 68.18% (95% CI, 29.72%-88.61%), 51.14% (95% CI, 14.5%-79.46%), and 25.57% (95% CI, 1.38%-64.78%), respectively. CONCLUSION Patient and graft survival rates after pediatric kidney transplantation in Indonesia are lower than those reported in other countries. Closer patient follow-up and stricter adherence to guidelines could improve transplant outcomes, but we must seek to improve the balance between infection and rejection.
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Affiliation(s)
- Cahyani Gita Ambarsari
- Department of Child Health, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
| | - Eka Laksmi Hidayati
- Department of Child Health, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
| | - Partini Pudjiastuti Trihono
- Department of Child Health, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
| | - Meilania Saraswati
- Department of Pathology Anatomy, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
| | - Arry Rodjani
- Department of Urology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
| | - Irfan Wahyudi
- Department of Urology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
| | - Gerhard Reinaldi Situmorang
- Department of Urology, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
| | - Jon Jin Kim
- Nottingham Children's Hospital, University of Nottingham, Nottingham, UK
| | - Omega Mellyana
- Department of Child Health, Faculty of Medicine, Universitas Diponegoro-Dr. Kariadi Hospital, Semarang, Indonesia
| | - Agustina Kadaristiana
- Department of Child Health, Faculty of Medicine, Universitas Indonesia-Cipto Mangunkusumo Hospital, Central Jakarta, Indonesia
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Tafuna'i M, Matalavea B, Voss D, Turner RM, Richards R, Sopoaga F, Hazelman L, Walker R. Kidney failure in Samoa. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2020; 5:100058. [PMID: 34327396 PMCID: PMC8315401 DOI: 10.1016/j.lanwpc.2020.100058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND There is limited literature on kidney disease in the Pacific Region, despite it being recognised as a leading cause of death in some Pacific Island nations. Kidney replacement therapy is only available in a handful of Pacific Islands. This paper reports the epidemiology of haemodialysis patients in Samoa. METHODS Registry data from the National Kidney Foundation of Samoa was analysed to estimate the incidence and prevalence rates of kidney failure from the rates of haemodialysis in Samoa and to explore some of the demographic features related to kidney failure in Samoa. FINDINGS In total, 393 patients have received long-term haemodialysis in the National Kidney Foundation of Samoa since its inception in 2005 until August 2019. 43% of the haemodialysis population were women and the mean age of people dialysed was 54.9 years. The crude mean incidence rate of kidney failure in Samoa, based on treated kidney failure cases, is 224 patients per million population with a crude prevalence of 629 patients per million population. Diabetic nephropathy (69.4%) was the leading cause of kidney failure. INTERPRETATION This is the first paper to report the epidemiology of haemodialysis patients in Samoa and reveals an urgent need for further studies on the extent of chronic kidney disease, and kidney failure, in Samoa to develop country specific prevention strategies to mitigate this growing burden and optimise care for kidney failure patients in Samoa. FUNDING : No funding was received for this study.
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Affiliation(s)
- Malama Tafuna'i
- National Kidney Foundation of Samoa, Apia, Samoa
- Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, PO Box 56, Dunedin 9054, New Zealand
| | | | - David Voss
- KidneyKare, Glen Innes, Auckland, New Zealand
| | - Robin M. Turner
- Centre for Biostatistics, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Rosalina Richards
- Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, PO Box 56, Dunedin 9054, New Zealand
| | - Fa'afetai Sopoaga
- Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, PO Box 56, Dunedin 9054, New Zealand
| | | | - Robert Walker
- Department of Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
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