Present status of renal replacement therapy in Asian countries as of 2017: Vietnam, Myanmar, and Cambodia

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Present status of renal replacement therapy in Asian countries as of 2017: Vietnam, Myanmar, and Cambodia Toru Hyodo1*, Masafumi Fukagawa1, Nobuhito Hirawa1, Yoshitaka Isaka1, Hidetomo Nakamoto2, Pham Van Bui3,4, Khin Thida Thwin5 and Chanseila Hy6

Abstract Since 2015, the Committee of 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. The aim of the symposium is to identify needs and find ways to contribute in the area of dialysis therapy in these countries. Three manuscripts are presented here by participants at the 2017 Asian symposium from Vietnam, Myanmar, and Cambodia. With economic development, hemodialysis (HD) therapy is now available worldwide. However, the cost of HD is very high compared with the average income in these three countries and, as of 2017, Cambodia and Myanmar have not yet established national health insurance systems. In Cambodia, patients must bear 100% of the cost for dialysis. In Myanmar, the government covers the cost of HD (20 USD, 40% of total cost) in public HD centers, but this service is still insufficient to meet current demand, with long waiting lists of up to 6 months at government HD centers. In contrast, in Vietnam, dialysis is almost completely covered by national health insurance. Dialyzers tend to be reused in all three countries. Continuous ambulatory peritoneal dialysis is available in Vietnam and Myanmar but not in Cambodia. Viable health insurance systems should be established as soon as possible in Cambodia and Myanmar, although this will ultimately depend on the countries’ level of economic development. Keywords: Committee of International Communication for Academic Research of the Japanese Society for Dialysis Therapy, Asian developing countries, Dialysis therapy, Economic development, Vietnam, Kidney transplantation, Chronic kidney disease, Peritoneal dialysis, Dialysis nurses, Dialysis doctors, Clinical engineers, Myanmar, Cambodia, Khmer Rouge-controlled state, Hemodialysis, National health insurance system

Background Preface: relationship between the Committee of International Communication for Academic Research of the Japanese Society for Dialysis Therapy and Asian developing countries until 2017

Toru Hyodo, Masafumi Fukagawa, Nobuhito Hirawa, Yoshitaka Isaka, Hidetomo Nakamoto, Japan * Correspondence: [email protected] 1 The Committee of International Communication for Academic Research of the Japanese Society for Dialysis Therapy, Tokyo, Japan Full list of author information is available at the end of the article

Recently, developing countries in Asia are showing marked economic development and rapid growth in terms of information and communications technology. These technologies allow physicians as well as the general public in these countries to learn about the latest treatments provided in developed countries as they occur. As a result, dem