Correspondence and Personal Opinion Dialysis practice from the English NHS to the orient

The dialysis modality mix in China is quite different from Hong Kong (HK). A recent article [1] about global differ-ences in dialysis modality mix showed interesting differ-ences in peritoneal dialysis (PD) prevalence in 36 countries (reported 2003–05) but omitted China and HK in its report. The Gross Domestic Product (GDP) per capita on health-care and the reimbursement rate of renal services were re-garded as the main determinants of the dialysis modality mix, although diabetes was associated with significantly less use of PD at Day 91. Diabetes is a common cause of end-stage kidney disease (ESKD) in the Orient. It is interesting that HK has a ‘PD first ’ policy, where 90 % of patients are on PD. Yet, in China, with a population of 1.3 billion, there are approxi-mately 260 000 people currently on haemodialysis (HD)