Makmun Afiatin, Satirapoj Bancha, Tuyen Do Gia, Foo Marjorie W Y, Danguilan Romina, Gulati Sanjeev, Kim Sejoong, Bavanandan Sunita, Chiu Yi-Wen, Tang Sydney C W
Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.
Division of Nephrology, Department of Medicine, Phramongkutkloa Hospital, Bangkok, Thailand.
Kidney Res Clin Pract. 2025 May;44(3):411-433. doi: 10.23876/j.krcp.23.194. Epub 2024 Sep 9.
The disease burden of chronic kidney disease (CKD) and its impact on healthcare systems has been poorly studied in Asia, a socioeconomically diverse region with wide variations in availability, access, and quality of CKD care. The high CKD burden in this region is predominantly driven by an increased prevalence of risk factors including diabetes mellitus, hypertension, obesity, and use of traditional medicines and is further aggravated by challenges associated with effective implementation of population-based screening and surveillance systems in early detection and intervention of CKD. The Asian continent mostly comprised of low- and middle-income countries with resource restraints lacks robust population-based CKD registries resulting in a paucity of data on CKD incidence and prevalence, various treatment modalities, uptake of current guidelines, and the overall impact of implementation of developmental programs. There is an urgent need for a collaborative action plan between the healthcare community and governments in this region to detect CKD in its early stages and prevent its complications including kidney failure, cardiovascular disease, and death. Research- based evidence on the impact of early detection, sustainable treatment options, quality of life, delay or avoidance of dialysis, and related cost analysis is the need of the hour. We highlight successful implementation of strategic and policy-sharing programs adopted in a few countries; also, consolidate available region-specific data, quantify estimates of CKD burden and propose strategies with a multidisciplinary approach involving patients, the healthcare community and governmental bodies to combat CKD and its complications.
慢性肾脏病（CKD）的疾病负担及其对医疗系统的影响在亚洲尚未得到充分研究。亚洲是一个社会经济多元化的地区，CKD护理的可及性、可获得性和质量存在很大差异。该地区CKD负担高的主要原因是包括糖尿病、高血压、肥胖和使用传统药物在内的危险因素患病率增加，此外，在CKD早期检测和干预中有效实施基于人群的筛查和监测系统所面临的挑战，进一步加重了这种负担。亚洲大陆大多是资源有限的低收入和中等收入国家，缺乏强大的基于人群的CKD登记系统，导致缺乏关于CKD发病率和患病率、各种治疗方式、现行指南的采用情况以及发展项目实施的总体影响的数据。该地区的医疗界和政府迫切需要制定一项合作行动计划，以便在早期阶段检测出CKD，并预防其并发症，包括肾衰竭、心血管疾病和死亡。目前亟需基于研究的证据，以了解早期检测的影响、可持续的治疗选择、生活质量、推迟或避免透析以及相关成本分析。我们重点介绍了一些国家成功实施的战略和政策共享计划；此外，汇总现有的特定区域数据，量化CKD负担估计，并提出一种涉及患者、医疗界和政府机构的多学科方法策略，以对抗CKD及其并发症。
