There is a clear need for coordination, collaboration and integration of initiatives to fight the epidemic of CKD in the Asian Pacific region; however, there is a considerable VX-689 amount of variability in the resource availability among different countries or regions. Access to global information and evidence databases is also limited in some. To overcome these limitations, it was agreed that AFCKDI could play a very valuable role in harmony with ISN (especially COMGAN activity) and APSN activity, and we should continue to embrace the opportunity in the form of this meeting further in the future. There is no question that this is also a very good opportunity to give strength
to networks and friendship of nephrologists in our region. click here Few countries have developed local evidence-based clinical www.selleckchem.com/products/BIBF1120.html practice guidelines (CPGs) for CKD. Fortunately, global CKD guideline development is now in progress, and the definition and classification system introduced by KDIGO has been well accepted in this area. However, several local issues need to be addressed. These include (1) estimated GFR equation(s) based on standardised creatinine estimation, which most efficiently reflect the Asian ethnicities, (2) efficient screening methods, which reflect
the common pathogenesis of CKD in Asian countries, and (3) short-term strategies for intervention. The ISN-KHDC programme for delaying progression could be applied in most of Asia areas regardless of economic status. Availability of interventions in other co-morbidities and complications of CKD, such as renal anaemia and CKD-MBD (mineral bone disease), varies among countries and regions because of economic status and/or public health policy. We also need to facilitate collaboration, coordination and integration of locally developed CPGs, aiming to resolve the gaps in clinical practice. There is substantial room for cooperation in implementing CPGs in the regions where resources are limited. There are good examples of corporation between developed and developing
countries. We need to acetylcholine expand this effort not just between two countries, but also among multiple relationships in our area by utilising the available resources of developed nations. ESRD is a very visible outcome of CKD, and the availability of RRT is drastically different among countries and regions in the Asian Pacific area. Many lives are still lost because of lack of access to RRT. An international registry of patients on RRT among multiple countries in our area would be valuable. Care of dialysis and renal transplant recipients can also be improved by implementing locally applicable global CPGs. More attention should be paid to previous live donors for renal transplantation because of the possible risk of future CKD.