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

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.