Aetiology, practice patterns and burden of end-stage kidney disease in South Asia and South-East Asia: A questionnaire-based survey

Sahay M 1 , Jasuja S 2 , Tang SCW 3 , Alexander S 4 , Jha V 5 , Vachharajani T 6 Show all authors , Mostafi M 7 , Pisharam JK 8 , Jacob C 9 , Gunawan A 10 , Bak Leong G 11 , Thwin KT 12 , Agrawal RK 13 , Vareesangthip K 14 , Tanchanco R 15 , Choong L 16 , Herath C 17 , Lin CC 18 , Cuong NT 19 , Haian HP 20 , Akhtar SF 21 , Alsahow A 22 , Rana DS 23 , Rajapurkar MM 24 , Kher V 25 , Verma S 26 , Ramachandran R 27 , Bhargava V 28 , Puri S 29 , Sagar G 2 , Bahl A 2 , Mandal S 30 , Gupta A 28 , Gallieni M 31

Affiliations 

  • 1 Department of Nephrology, Osmania General Hospital, Hyderabad, India
  • 2 Department of Nephrology, Indraprastha Apollo Hospital, Delhi, India
  • 3 Department of Nephrology, Queen Mary Hospital, Hong Kong Society of Nephrology, Pok Fu Lam, Hong Kong
  • 4 Department of Nephrology, Christian Medical College Vellore, Tamil Nadu, 632004, India
  • 5 Department of Nephrology, George Institute of Global Health, Delhi, India
  • 6 Department of Nephrology, Cleveland Clinic, Cleveland, Ohio, USA
  • 7 Department of Nephrology, Armed Forces Medical College, Dhaka, Bangladesh
  • 8 Department of Nephrology, Ministry of Health, Brunei, Darussalam Medical Services, Bandar Seri Begawan, Brunei Darussalam
  • 9 Department of Nephrology, Bengaluru, Bangalore Baptist Hospital, India
  • 10 Department of Nephrology, Brawijaya University, Malang, Indonesia
  • 11 Department of Nephrology, Serdang Hospital, Serdang, Malaysia
  • 12 Department of Nephrology, University of Medicine, Yangon, Myanmar
  • 13 Department of Nephrology, Bir Hospital, Kathmandu, Nepal
  • 14 Department of Nephrology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 15 Department of Nephrology, The Medical City, Metro Manila, Philippines
  • 16 Department of Nephrology, Singapore General Hospital, Singapore, Singapore
  • 17 Department of Nephrology, Sri Jayewardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka
  • 18 Department of Nephrology, Taipei Veterans General Hospital, Taipei, Taiwan
  • 19 Department of Nephrology, Hochiminh City National University, Hochiminh, Vietnam
  • 20 Department of Nephrology, Viet Duc University Hospital, Hanoi, Vietnam
  • 21 Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
  • 22 Department of Nephrology, Jahara Hospital, Al Jahra, Kuwait
  • 23 Department of Nephrology, Sir Gangaram Hospital, Delhi, India
  • 24 Department of Nephrology, Muljibhai Patel Urological Hospital, Gujrat, India
  • 25 Department of Nephrology, Medanta Hospital Gurugram, Gurugram, India
  • 26 Clinical Research, AVATAR foundation, New Delhi, India
  • 27 Department of Nephrology, PGIMER, Chandigarh, India
  • 28 Department of Nephrology, Sir Ganga Ram Hospital, Delhi, India
  • 29 Department of Nephrology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersy, USA
  • 30 Department of Nephrology, Columbia Asia Hospital, Gurugram, India
  • 31 Department of Nephrology, 'L. Sacco' Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy
Nephrology (Carlton), 2021 Feb;26(2):142-152.
PMID: 33169890 DOI: 10.1111/nep.13825

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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