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AVATAR Foundation Initiative: ESKD in South Asia and South-East Asia.

AIM
There is paucity of data on the epidemiology of end-stage kidney disease from South Asia and South-East Asia. The objective of this study was to assess the etiology, practice patterns & disease burden and growth of end stage kidney disease in the region comparing the economies.


METHODS
The national nephrology societies of the region; responded to 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 end stage kidney disease. Diabetes, Hypertension and chronic glomerulonephritis were most common causes. The mean age in Group-2 was lower by a decade (Group-2 vs. Group-1 - 47.7vs. 59.45years).


CONCLUSION
Hemodialysis 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 Hemodialysis & Peritoneal dialysis.