A Haemodialysis Journey from the West to the East

Nephrology and dialysis have travelled a long way in the UK in the last 2 decades when I had been working there. In the early 1990s, the HD take-on rate in the UK was merely about 50 per million population (pmp) per year. Even in the mid-1990s, peritoneal dialysis (PD) was the default treatment, and twiceinstead of thrice-a-week HD was necessary in some parts of the country because of lack of HD slots. But from 2005 onwards, and largely due to increased NHS investment, the UK take-on rate has increased significantly, reaching 400 pmp per year in the u003e70-year-olds in 2010, and patients were given free choices between HD and PD. In China, in 2013, there were 260,000 patients on HD against 40,000 on PD. The patient ratio for HD to PD is roughly 7 to 1 due to the favourable insurance reimbursement for hospital HD compared to PD [3] . To cater for the demand, many of the new hospital HD centres have over 50 HD stations [4] , including ours designed for 69 HD stations. Yet, almost half of the Chinese HD patients are on twiceinstead of thrice-a-week HD to reduce the high HD co-payment charges. Now, when I recollect my UK journey, it seems that I am re-living a similar time again in China, but there Shenzhen, China