Publication: Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia
Issued Date
2021-01-01
Resource Type
ISSN
20902158
2090214X
2090214X
Other identifier(s)
2-s2.0-85106388483
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Nephrology. Vol.2021, (2021)
Suggested Citation
Suceena Alexander, Sanjiv Jasuja, Maurizio Gallieni, Manisha Sahay, Devender S. Rana, Vivekanand Jha, Shalini Verma, Raja Ramachandran, Vinant Bhargava, Gaurav Sagar, Anupam Bahl, Mamun Mostafi, Jayakrishnan K. Pisharam, Sydney C.W. Tang, Chakko Jacob, Atma Gunawan, Goh B. Leong, Khin T. Thwin, Rajendra K. Agrawal, Kriengsak Vareesangthip, Roberto Tanchanco, Lina H.L. Choong, Chula Herath, Chih C. Lin, Nguyen T. Cuong, Ha P. Haian, Syed F. Akhtar, Ali Alsahow, Mohan M. Rajapurkar, Vijay Kher, Hemant Mehta, Anil K. Bhalla, Umesh B. Khanna, Deepak S. Ray, Sonika Puri, Himanshu Jain, Aida Lydia, Tushar Vachharajani Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia. International Journal of Nephrology. Vol.2021, (2021). doi:10.1155/2021/6665901 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/78731
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia
Author(s)
Suceena Alexander
Sanjiv Jasuja
Maurizio Gallieni
Manisha Sahay
Devender S. Rana
Vivekanand Jha
Shalini Verma
Raja Ramachandran
Vinant Bhargava
Gaurav Sagar
Anupam Bahl
Mamun Mostafi
Jayakrishnan K. Pisharam
Sydney C.W. Tang
Chakko Jacob
Atma Gunawan
Goh B. Leong
Khin T. Thwin
Rajendra K. Agrawal
Kriengsak Vareesangthip
Roberto Tanchanco
Lina H.L. Choong
Chula Herath
Chih C. Lin
Nguyen T. Cuong
Ha P. Haian
Syed F. Akhtar
Ali Alsahow
Mohan M. Rajapurkar
Vijay Kher
Hemant Mehta
Anil K. Bhalla
Umesh B. Khanna
Deepak S. Ray
Sonika Puri
Himanshu Jain
Aida Lydia
Tushar Vachharajani
Sanjiv Jasuja
Maurizio Gallieni
Manisha Sahay
Devender S. Rana
Vivekanand Jha
Shalini Verma
Raja Ramachandran
Vinant Bhargava
Gaurav Sagar
Anupam Bahl
Mamun Mostafi
Jayakrishnan K. Pisharam
Sydney C.W. Tang
Chakko Jacob
Atma Gunawan
Goh B. Leong
Khin T. Thwin
Rajendra K. Agrawal
Kriengsak Vareesangthip
Roberto Tanchanco
Lina H.L. Choong
Chula Herath
Chih C. Lin
Nguyen T. Cuong
Ha P. Haian
Syed F. Akhtar
Ali Alsahow
Mohan M. Rajapurkar
Vijay Kher
Hemant Mehta
Anil K. Bhalla
Umesh B. Khanna
Deepak S. Ray
Sonika Puri
Himanshu Jain
Aida Lydia
Tushar Vachharajani
Other Contributor(s)
Rabindranath Tagore International Institute of Cardiac Sciences
Siriraj Hospital
Bir Hospital
Sri Jayewardenepura General Hospital
Osmania General Hospital
Brawijaya University
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Sindh Institute of Urology and Transplantation
Muljibhai Patel Urological Hospital
Queen Mary Hospital Hong Kong
Rutgers Robert Wood Johnson Medical School
Sir Ganga Ram Hospital
Cleveland Clinic Foundation
Indraprastha Apollo Hospitals
Singapore General Hospital
Veterans General Hospital-Taipei
Ospedale Luigi Sacco - Polo Universitario
Christian Medical College, Vellore
Postgraduate Institute of Medical Education & Research, Chandigarh
Lancelot Kidney and GI Centre
The Medical City
University of Medicine
Viet Duc University Hospital
Medanta Medicity
Avatar Foundation
Bangalore Baptist Hospital
Ministry of Health
Jahra Hospital
George Institute of Global Health
Lilawati Hospital
Hospital Serdang
Armed Forces Medical Institute
Siriraj Hospital
Bir Hospital
Sri Jayewardenepura General Hospital
Osmania General Hospital
Brawijaya University
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Sindh Institute of Urology and Transplantation
Muljibhai Patel Urological Hospital
Queen Mary Hospital Hong Kong
Rutgers Robert Wood Johnson Medical School
Sir Ganga Ram Hospital
Cleveland Clinic Foundation
Indraprastha Apollo Hospitals
Singapore General Hospital
Veterans General Hospital-Taipei
Ospedale Luigi Sacco - Polo Universitario
Christian Medical College, Vellore
Postgraduate Institute of Medical Education & Research, Chandigarh
Lancelot Kidney and GI Centre
The Medical City
University of Medicine
Viet Duc University Hospital
Medanta Medicity
Avatar Foundation
Bangalore Baptist Hospital
Ministry of Health
Jahra Hospital
George Institute of Global Health
Lilawati Hospital
Hospital Serdang
Armed Forces Medical Institute
Abstract
Background. The association between economic status and kidney disease is incompletely explored even in countries with higher economy (HE); the situation is complex in lower economies (LE) of South Asia and Southeast Asia (SA and SEA). Methods. Fifteen countries of SA and SEA categorized as HE and LE, represented by the representatives of the national nephrology societies, participated in this questionnaire and interview-based assessment of the impact of economic status on renal care. Results. Average incidence and prevalence of end-stage kidney disease (ESKD) per million population (pmp) are 1.8 times and 3.3 times higher in HE. Hemodialysis is the main renal replacement therapy (RRT) (HE-68%, LE-63%). Funding of dialysis in HE is mainly by state (65%) or insurance bodies (30%); out of pocket expenses (OOPE) are high in LE (41%). Highest cost for hemodialysis is in Brunei and Singapore, and lowest in Myanmar and Nepal. Median number of dialysis machines/1000 ESKD population is 110 in HE and 53 in LE. Average number of machines/dialysis units in HE is 2.7 times higher than LE. The HE countries have 9 times more dialysis centers pmp (median HE-17, LE-02) and 16 times more nephrologist density (median HE-14.8 ppm, LE-0.94 ppm). Dialysis sessions >2/week is frequently followed in HE (84%) and <2/week in LE (64%). "On-demand"hemodialysis (<2 sessions/week) is prevalent in LE. Hemodialysis dropout rates at one year are lower in HE (12.3%; LE 53.4%), death being the major cause (HE-93.6%; LE-43.8%); renal transplants constitute 4% (Brunei) to 39% (Hong Kong) of the RRT in HE. ESKD burden is expected to increase >10% in all the HE countries except Taiwan, 10%-20% in the majority of LE countries. Conclusion. Economic disparity in SA and SEA is reflected by poor dialysis infrastructure and penetration, inadequate manpower, higher OOPE, higher dialysis dropout rates, and lesser renal transplantations in LE countries. Utility of RRT can be improved by state funding and better insurance coverage.