Hemodialysis in Asia

Background: Asia is the largest, most populous and most heterogeneous continent in the world. The number of patients with end-stage renal disease is growing rapidly in Asia. Summary: A fully informed report on the status of dialysis therapies including hemodialysis (HD) is limited by the lack of systematic registries. Available data suggest remarkable heterogeneities, with some countries like Taiwan, Japan and Korea exhibiting well-established HD systems, high prevalence and universal access to all patients, while lowand lowmiddle income countries are unable to provide HD to eligible patients because of high cost and poor healthcare systems. Many Asian countries have unregulated dialysis units, with poor standards of delivery, quality control and outcome reporting. This leads to high mortality due to preventable complications like infections. Modeling data suggest that at least 2.9 million people need dialysis in Asia, which represents a gap in availability of dialysis to the tune of –66%. The population is projected to grow rapidly in the coming years. Several countries are expanding access to HD. Innovative modifications in dialysis practice are being made to optimize outcomes. It is important to develop robust systems of documentation and outcome reporting to evaluate the effects of such changes. HD needs to develop in conjunction with effective preventive programs and improvement of health Received: October 4, 2015 Accepted: October 18, 2015 Published online: November 18, 2015 Prof. Vivekanand Jha George Institute for Global Health Splendor Forum, Jasola New Delhi 110 025 (India) E-Mail vjha @ pginephro.org © 2015 S. Karger AG, Basel 2296–9381/15/0013–0165$39.50/0 www.karger.com/kdd For chronic hemodialysis therapy in the West, see Rocco, Kidney Dis