{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:45:14Z","timestamp":1791240314685,"version":"4.1.0"},"reference-count":66,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The Diversity and Equity Committee (DEC) of the Asian Pacific Society of Nephrology (APSN) conducted a regional review to characterise disparities in kidney disease burden, healthcare access and nephrology service delivery across the Asia\u2010Pacific (AP) region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive summary was compiled using national reports, registries, and expert inputs from DEC representatives. Data included kidney disease prevalence, dialysis and transplant modalities, healthcare system characteristics and disparity\u2010related indicators. Comparative insights were drawn across countries using structured tables and narrative synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The AP region exhibits a disproportionate burden of chronic kidney disease (CKD) and kidney failure with marked heterogeneity in disease aetiology, healthcare financing, and infrastructure. High\u2010income countries such as Japan, Korea, Taiwan and Australia demonstrate mature universal insurance systems, comprehensive dialysis networks and national CKD prevention programs. Middle\u2010 and lower\u2010income countries\u2014including Indonesia, Myanmar, Mongolia and parts of South and Southeast Asia\u2014face critical challenges such as workforce shortages, limited dialysis and transplant capacity and geographic inequities. Despite these challenges, several countries have introduced exemplary models to enhance equity and sustainability in kidney care: PD\u2010first policies (Hong Kong, Thailand), pay\u2010for\u2010performance CKD programs (Taiwan), Kidney Health Plan 2033 (Korea), HALT\u2010CKD (Singapore), and ACT\u2010KID (Malaysia), indigenous kidney health efforts in Australia and the inclusion of additional insurance points for patient education in Japan. Persistent gaps remain in early detection, transplantation access, rural care and minority equity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Kidney disease care in the Asia\u2013Pacific region reflects both diversity and disparity. Although universal health coverage and national kidney health initiatives have improved access in many countries, substantial inequities persist across geography, income and cultural groups. The collective experiences highlight both common challenges and innovative solutions. Strengthening regional collaboration, policy\u2010driven efforts and sustainable workforce development are essential to achieving equitable kidney health for all.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70186","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T01:24:44Z","timestamp":1773365084000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Disease Burden and Disparities of Care for Kidney Health in the Asian Pacific Region: Summary Report From the Diversity and Equity Committee of\n                    <scp>APSN<\/scp>"],"prefix":"10.1111","volume":"31","author":[{"given":"I\u2010Wen","family":"Wu","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Taipei Medical University Hospital  Taipei Taiwan"},{"name":"Division of Nephrology, Department of Internal Medicine School of Medicine, College of Medicine, Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayne Cho","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine Kangnam Sacred Heart Hospital  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8161-1679","authenticated-orcid":false,"given":"Jia Liang","family":"Kwek","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Singapore General Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Kwan","sequence":"additional","affiliation":[{"name":"Department of Medicine Queen Mary Hospital and Tung Wah Hospital  Hong Kong Hong\u00a0Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saruultuvshin","family":"Adiya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mongolia Japan Hospital, Mongolian National University of Medical Sciences  Ulaanbaatar Mongolia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9695-0761","authenticated-orcid":false,"given":"Shilpanjali","family":"Jesudason","sequence":"additional","affiliation":[{"name":"Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Central Adelaide Local Health Network  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan Chong Men","family":"Leong","sequence":"additional","affiliation":[{"name":"Division of Nephrology Sunway Medical Centre Penang  Pulau Pinang Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khin Phyu","family":"Pyar","sequence":"additional","affiliation":[{"name":"Department of Nephrology Defence Services Medical Academy No. 1, Defence Services General Hospital  Yangon Myanmar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Warangkana","family":"Pichaiwong","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Medicine Rajavithi Hospital, College of Medicine, Rangsit University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kornchanok","family":"Vareesangthip","sequence":"additional","affiliation":[{"name":"Renal Division, Department of Medicine Faculty of Medicine Siriraj Hospital, Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pringgodigdo","family":"Nugroho","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine Faculty of Medicine, Universitas Indonesia; Dr. Cipto Mangunkusumo Hospital  Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew David","family":"Henderson","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Waikato Hospital  Hamilton New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqiang","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Nephrology Zhongshan Hospital, Fudan University  Shanghai China"},{"name":"Shanghai Medical Center of Kidney Disease  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj Narayan","family":"Manandhar","sequence":"additional","affiliation":[{"name":"Department of Nephrology Nepal Medical College and Teaching Hospital  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihyun","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoko","family":"Yanagita","sequence":"additional","affiliation":[{"name":"Department of Nephrology Kyoto University Graduate School of Medicine  Kyoto Japan"},{"name":"Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2013.07.008"},{"key":"e_1_2_8_3_1","volume-title":"USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States","author":"United States Renal Data System","year":"2024"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.0000000688"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-024-00885-3"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1813869"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2008.129"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNH.0000000000001023"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000514550"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.0000000000000238"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-024-00820-6"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2024.02.001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-019-01720-x"},{"key":"e_1_2_8_14_1","first-page":"543","article-title":"Annual Dialysis Data Report, JSDT Renal Data Registry","volume":"57","author":"Masakane T.","year":"2023","journal-title":"Nihon Toseki Igakkai Zasshi\u2014Journal of the Japanese Society for Dialysis Therapy. 2024"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-024-02497-4"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/17571472.2010.11493315"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2022.100485"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp259"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.70055"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000512855"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.22.039"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.22.103"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000524110"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2025.08.040"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.23.232"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.23876\/j.krcp.23.267"},{"key":"e_1_2_8_27_1","unstructured":"Kidney Health Australia \u201cChanging the Chronic Kidney Disease Landscape: The Economic Benefits of Early Detection and Treatment. Deloitte Access Economics \u201d(2023)."},{"key":"e_1_2_8_28_1","unstructured":"Kidney Health Australia \u201cNational Strategic Action Plan for Kidney Disease \u201d(2019)."},{"key":"e_1_2_8_29_1","unstructured":"G.Irish C.Davies E.Au et\u00a0al. \u201cIncidence of Kidney Failure With Replacement Therapy. Australia and New Zealand Dialysis and Transplant Registry. 47th Report \u201d(Adelaide Australia: 2024) http:\/\/www.anzdata.org.au."},{"key":"e_1_2_8_30_1","unstructured":"N.Cross I.Dittmer andP.Matheson \u201cPolicy for Use of New Zealand Survival After Kidney Transplant Predictor System in Patients Assessed for Deceased Donor Transplantation in New Zealand (Version 1.0) \u201dOn behalf of New Zealand Renal Advisory Board (2012)."},{"key":"e_1_2_8_31_1","unstructured":"\u201cPrimary Healthcare Blueprint Health Bureau Hong Kong \u201din Region HBTGotHSA (People's Republic of China) https:\/\/www.healthbureau.gov.hk\/download\/press_and_publications\/otherinfo\/221200_primary_healthcare\/e_primary_healthcare_blueprint.pdf."},{"key":"e_1_2_8_32_1","unstructured":"\u201cOverview of Healthcare System in Hong Kong \u201daccessed 8 September 2025 https:\/\/www.gov.hk\/en\/residents\/health\/hosp\/overview.htm."},{"key":"e_1_2_8_33_1","unstructured":"\u201cHong Kong's Current Healthcare Financing Arrangements \u201daccessed on 8Sep tember 2025 https:\/\/www.healthbureau.gov.hk\/beStrong\/files\/consultation\/appendixc_eng.pdf."},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2015.7"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.14042"},{"key":"e_1_2_8_36_1","first-page":"332","article-title":"The Hong Kong Renal Registry: A Recent Update","volume":"30","author":"Chan J. Y. H.","year":"2024","journal-title":"Hong Kong Medical Journal"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2019.05.016"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-020-01966-8"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00252-X"},{"key":"e_1_2_8_40_1","unstructured":"\u201cHealthhub: Costs and Financing \u201daccessed 7 September 2025 https:\/\/www.healthhub.sg\/support\u2010and\u2010tools\/costs\u2010and\u2010financing\/costs_and_financing_overall."},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.47102\/annals-acadmedsg.2023399"},{"key":"e_1_2_8_42_1","unstructured":"\u201cNational Kidney Foundation Outreach Programmes \u201daccessed 7 September 2025 https:\/\/nkfs.org\/outreach\u2010programmes\/."},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2021.01.011"},{"key":"e_1_2_8_44_1","unstructured":"\u201cDepartment for Regulating Cell Tissue and Organ Transplantation Center for Health Development Mongolia \u201dhttps:\/\/hdc.gov.mn\/page\/139\/."},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0000762020"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40545-023-00643-z"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp669"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2024.100406"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-09387-w"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2024.05.012"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2017.02.008"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0002102021"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31647-7"},{"key":"e_1_2_8_54_1","volume-title":"11th Report of Indonesian Renal Registry","author":"Indonesian Society of Nephrology","year":"2018"},{"key":"e_1_2_8_55_1","unstructured":"Indonesian Society of Nephrology \u201cIndonesian Renal Registry Report and Optimalization for Research and Publication \u201d(Jakarta InaSN: 2023)."},{"key":"e_1_2_8_56_1","doi-asserted-by":"crossref","unstructured":"A.Lydia I. G. R.Widiana R.Bandiara et\u00a0al. \u201cNephrology in Indonesia \u201d(2021).","DOI":"10.1007\/978-3-030-56890-0_22"},{"key":"e_1_2_8_57_1","first-page":"1","article-title":"Chronic Kidney Disease Care in Indonesia: Challenges and Opportunities","volume":"55","author":"Hustrini N. M.","year":"2023","journal-title":"Acta Medica Indonesiana"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.37871\/jbres1553"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41100-020-00312-w"},{"key":"e_1_2_8_60_1","unstructured":"K. P.Pyar M.Myint M.Zaw et\u00a0al. \u201cKnowledge and Attitude Towards Home Based Dialysis Therapy in Myanmar: The Way Forward!\u201d(2023) 5 548\u2013555."},{"key":"e_1_2_8_61_1","first-page":"2005","article-title":"A\u201028\u2010Years\u2010Old Man Received Kidney With Double Renal Arteries and Veins From Younger Sister: A Successful Laparoscopic Living Donor Nephrectomy","volume":"4","author":"Khin Phyu P.","year":"2024","journal-title":"International Journal of Medical Science and Clinical Research Studies"},{"key":"e_1_2_8_62_1","unstructured":"\u201cNational Population and and Housing Census 2021 Results \u201d(2021) https:\/\/censusnepal.cbs.gov.np\/results."},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.2530"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0001672022"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/hdi.12629"},{"key":"e_1_2_8_66_1","doi-asserted-by":"crossref","unstructured":"D.Sharma T.Sharma andJ.Tang \u201cNephrology in Nepal: How it Started and Where We Are \u201d(2025) Kidney360.","DOI":"10.34067\/KID.0000000991"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.3389\/ti.2023.11635"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70186","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.70186","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70186","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T02:08:51Z","timestamp":1776046131000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70186"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":66,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/nep.70186"],"URL":"https:\/\/doi.org\/10.1111\/nep.70186","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70186"}}