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Perit Dial Int 28(1): 13-19 2008
© 2008 International Society for Peritoneal Dialysis
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PD IN THE DEVELOPING WORLD

CHRONIC PERITONEAL DIALYSIS IN SOUTH ASIA — CHALLENGES AND FUTURE

Georgi Abraham1, Balaji Pratap1, Suresh Sankarasubbaiyan2, Priyanka Govindan1, K. Shivanand Nayak3, Rezvi Sheriff4 and S.A. Jaffar Naqvi5

Sri Ramachandra University Hospital1 ; Sundaram Medical Foundation,2 Chennai; Global Hospital,3 Hyderabad, India; Western Infirmary,4 Colombo, Sri Lanka; and Pakistan Kidney Foundation,5 Karachi, Pakistan

Correspondence to: G. Abraham, Sri Ramachandra Medical College and Research Institute, Chennai, 600 116, India. abraham_georgi{at}yahoo.com

Chronic peritoneal dialysis (PD), especially continuous ambulatory PD (CAPD), is being increasingly utilized in South Asian countries (population of 1.4 billion). There are divergent geopolitical and socioeconomic factors that influence the growth and expansion of CAPD in this region. The majority of the countries in South Asia are lacking in government healthcare system for reimbursing renal replacement therapy. The largest utilization of chronic PD is in India, with nearly 6500 patients on this treatment by the end of 2006. A large majority of patients are doing 2 L exchanges 3 times per day, using glucose-based dialysis solution manufactured in India. Chronic PD is not being utilized in Myanmar, Bhutan, or Seychelles. Affirmative action by the manufacturing industry, medical professionals, government policy makers, and nongovernmental organizations for reducing the cost of chronic PD will enable the growth and utilization of this life-saving therapy.

KEY WORDS: Chronic peritoneal dialysis; South Asian countries; socioeconomic and geopolitical diversity.

Received 6 March 2007; accepted 30 November 2007.






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