Abstract
Since 2015, the Committee for 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 in order to identify needs and find ways to contribute to these countries in the area of dialysis therapy. Five manuscripts are presented here by symposium participants from Cambodia, Laos, Bhutan, Mongolia, and Indonesia from the Asian symposium of 2016.With progress in economic development, hemodialysis (HD) therapy has now been introduced in all countries worldwide. However, the cost of HD is extremely high compared with typical incomes in every country, and as of 2016, many countries still have not established national health insurance systems. In Cambodia and Laos, for example, patients must bear 100% of the cost for dialysis. In contrast, in Bhutan, the government bears all costs and the patients need not pay at all. In Mongolia and Indonesia, dialysis is almost completely covered by national health insurance. Dialyzers tend to be reused in Cambodia, Laos, and Indonesia. In Mongolia and Bhutan, dialyzers are single-use only. Continuous ambulatory peritoneal dialysis is available in Mongolia and Indonesia but is just starting to be introduced in Laos; it is not available in Cambodia and Bhutan. In Cambodia and Laos where there is no national health insurance system, patients with lower socioeconomic status come to the HD center only when they have enough money to pay for an HD session. Viable health insurance systems should be established as soon as possible. However, this will ultimately depend on the countries’ economic development.
Highlights
Patients of lower socioeconomic status come to the HD center only when they have enough money to pay for an HD session
Lao People’s Democratic Republic (PDR) is a land-locked country located in the heart of the Indochina Peninsula of Southeast Asia, bordered by Cambodia to the south, China to the north, Vietnam to the east, Thailand to the west, and Myanmar to the northwest
We retrospectively analyzed end-stage renal disease (ESRD) patients treated in our HD center at Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu, Bhutan
Summary
Mongolia has an estimated population of 3,000,000 as of 2015, with a total land area of 1,564,116 km. Future challenges of ESRD in Indonesia In summary, the challenges facing dialysis treatment in Indonesia are the increasing number of ESRD patients that need regular dialysis and the increasing national economic burden from HD This may be associated with the increasing prevalence of primary causative diseases, mainly hypertension (37%) and diabetes mellitus (27%) (National Health Survey 2013) [2], and total access (universal coverage) to national health insurance. We need (1) nationwide campaigns and integrated action for prevention in hypertension and diabetes mellitus, (2) early detection through screening programs and prompt treatment of kidney disease, (3) implementation of the PD-first policy as a more cost-effective measure, (4) relocation of manufacturing plants for dialyzers and dialysis solution to Indonesia, and (5) a tax-free policy on imported dialysis goods.
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