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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
In 2008, Thailand implemented a policy known as "Peritoneal Dialysis (PD) First" under its Universal Coverage Scheme. This policy designated PD as the initial modality of renal replacement therapy (RRT) for eligible patients with end-stage kidney disease. Although the policy was designed to improve accessibility to RRT, little is known about how it has influenced geographical equity in access to RRT services. This study investigated nationwide changes between 2015 and 2019 in the distribution of institutions offering PD, hemodialysis (HD), and kidney transplantation (KT), as well as regional patterns in patients receiving these treatments. We also examined whether disparities are associated with socioeconomic development levels.
We utilized the national RRT registration database, managed by the National Health Security Office, which covers approximately 76% of the Thai population. The number of healthcare institutions offering PD, HD, and KT was evaluated annually at national and provincial levels. For each province, we calculated the age- and sex-standardized ratios of PD and HD utilization using the 2015 national population of the Universal Coverage Scheme as a reference. The extent of regional variation was assessed by calculating the standard deviation of these ratios each year. We also examined associations between RRT utilization and provincial Human Achievement Index scores, which reflect various aspects of socioeconomic development, using one-way analysis of variance.
A total of 57,273 patients initiated RRT from 2015 to 2019. Of these patients, 38,522 received PD, 17,947 received HD, and 804 underwent KT. The number of institutions providing PD increased from 168 to 259, while those offering HD increased from 486 to 594. The proportion of PD among new RRT cases increased from 63.5% to 69.9%, while HD decreased from 34.4% to 29.2%, and KT declined from 2.1% to 0.9%. The standard deviation of the provincial standardized PD ratios increased from 0.46 in 2015 to 0.87 in 2019, indicating a widening regional gap in utilization. The HD ratios remained relatively stable, with standard deviations ranging from 0.60 to 0.64. Although many provinces showed an increase in PD utilization, Bangkok experienced a notable decrease. The HD utilization showed consistent positive associations with the Human Achievement Index throughout the study period, suggesting that more developed provinces used HD more frequently. In contrast, association between PD utilization and the index were observed only in 2015 and were not statistically significant in subsequent years.
The PD First policy in Thailand contributed to a substantial national increase in both access to PD and the number of institutions delivering RRT services. However, the regional disparity in PD utilization became more pronounced during the study period. Additional efforts may be needed to address these emerging inequalities. Findings from Thailand’s experience may serve as guidance for other countries that aim to scale up cost-effective RRT services.
