Global Dialysis Perspective: Vietnam.

Abstract

Vietnam is one of the most populated Southeast Asian countries, with a population of around 97 million people in 2018 (1). Three kinds of RRT, including hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation, are currently available in Vietnam; they service a total of about 36,000 patients, but this only accounts for about one third of the estimated ESKD population in need of dialysis across the country. The purpose of this article is to give a broad overview of some key aspects of RRT and nephrology in Vietnam. HD has been available in Vietnam since 1968. Initially, it was only used to treat acute kidney failure. During that period, only the Travenol Drake-Willock machine was used. Starting from 1996, with the initiation of the national insurance reimbursement system, a remarkable development in dialysis was seen throughout the country, with the number of patients on maintenance hemodialysis (MHD) steeply increasing. MHD has become the most common type of dialysis and has been available in many Vietnamese cities and provinces since then (2). Although little is known about the actual number of patients with ESKD in need of dialysis in the general population, it is estimated to be >100,000 persons. However, only about one third of them (approximately 30,000 patients) are actually on MHD all over the country. Although this proportion is still very low compared with the estimated demand, all dialysis facilities are frequently overwhelmed and have to operate up to four 4-hour shifts per day; home dialysis is not available yet in Vietnam. All dialyzers are capillary type, mainly low flux, and they are reused six times in total to compensate for the low reimbursement of only $25 per session. We import all dialysis machines and dialyzers from various foreign brands, such as Nipro (Japan), B. Braun, and Fresenius (Germany), …