Summary
Chronic kidney disease (CKD) is a major health problem for the underdeveloped countries
of southeast Asia, home to more than 2 billion people. The true incidence and prevalence
in the region is not known, but estimates suggest that the prevalence may be more
than that reported in Western societies. The majority of affected individuals are
young and in the most productive years of their lives. The looming epidemic of diabetes
and hypertension is likely to further add to the disease burden. A high prevalence
has been reported from some regions, suggesting the presence of unique etiologic factors.
A large proportion of patients present late, with advanced kidney failure and multiple
complications. Management is hampered by the lack of health care services, especially
in the rural areas. The health care expenditure by the governments in these countries
is very low, and there are no regional or national policies for chronic disease management
including CKD. There is a major shortage of trained nephrologists. In absence of any
government or private reimbursement, most patients cannot afford the high treatment
cost. Renal replacement therapy is available only to a minority. The practice of dialysis
in the region is not standardized and a large number of patients develop complications.
There is an urgent need to develop CKD detection and prevention programs. Investigations
are required to characterize the unique etiologic factors in different geographic
regions so that prevention programs can be targeted appropriately. Cost-cutting strategies
would make renal replacement therapy accessible to the general population. According
sufficient prominence to CKD in education programs would help increase awareness.
Keywords
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