The path to safe, equitable and sustainable dialysis provision for people with chronic kidney disease

Nature Medicine Commission on Dialysis Policy in Low- and Middle-Income Countries; Research teams; Secretariat team for the NHSO Working Group; The NHSO Working Group; Secretariat team for the Learning Committee; The Learning Committee

doi:10.1038/s41591-025-04144-1

The path to safe, equitable and sustainable dialysis provision for people with chronic kidney disease

Nature Medicine Commission on Dialysis Policy in Low- and Middle-Income Countries
, Research teams
, Secretariat team for the NHSO Working Group
, The NHSO Working Group
, Secretariat team for the Learning Committee
, The Learning Committee

Health Intervention and Technology Assessment Program
NUS
Faculty of Medicine, Chulalongkorn University
King Chulalongkorn Memorial Hospital
Thailand Development Research Institute
University of Strathclyde
Obafemi Awolowo University
University of Yaounde
National Health Security Office
Dialysis Center CASMU-IAMPP
Banphaeo Hospital
National Health Foundation, Thailand
International Health Policy Program, Thailand
Ministry of Public Health
University of Hong Kong
Harvard Medical School
University of Cape Town
University Children's Hospital of Zurich
Faculty of Medicine, Chiang Mai University
Institute of Health Policy, Management and Evaluation
UNSW Sydney
Imperial College London
Prasanna School of Public Health
Bhumirajanakarindra Kidney Institute Hospital
The Medical Association of Thailand
Silpakorn University
Chaiyaphum Hospital
Kantharalak hospital
Chulalongkorn University
Duke-NUS Medical School
Bangkhla Hospital
Maharaj Hospital
Rajavithi Hospital
Thai Kidney Friends Association
Health Systems Research Institute (HSRI) - สถาบันวิจัยระบบสาธารณสุข (สวรส.)
Pinkanakorn Development Agency
Siriraj Hospital

Research output: Contribution to journal › Comment/debate

Abstract

An abrupt policy change in 2022 — allowing patients to choose between peritoneal dialysis or hemodialysis — created severe unintended consequences for the Thai health system. A multidisciplinary commission found that interacting factors in the system were overlooked and that future dialysis policies must integrate more-diverse evidence and stakeholder views, prioritizing care quality and ethics while balancing equity and sustainability.

Original language	English
Pages (from-to)	44-46
Number of pages	3
Journal	Nature Medicine
Volume	32
Issue number	1
DOIs	https://doi.org/10.1038/s41591-025-04144-1
Publication status	Published - Jan 2026

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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10.1038/s41591-025-04144-1

Cite this

Nature Medicine Commission on Dialysis Policy in Low- and Middle-Income Countries, Research teams, Secretariat team for the NHSO Working Group, The NHSO Working Group, Secretariat team for the Learning Committee, & The Learning Committee (2026). The path to safe, equitable and sustainable dialysis provision for people with chronic kidney disease. Nature Medicine, 32(1), 44-46. https://doi.org/10.1038/s41591-025-04144-1

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abstract = "An abrupt policy change in 2022 {\textemdash} allowing patients to choose between peritoneal dialysis or hemodialysis {\textemdash} created severe unintended consequences for the Thai health system. A multidisciplinary commission found that interacting factors in the system were overlooked and that future dialysis policies must integrate more-diverse evidence and stakeholder views, prioritizing care quality and ethics while balancing equity and sustainability.",

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Nature Medicine Commission on Dialysis Policy in Low- and Middle-Income Countries, Research teams, Secretariat team for the NHSO Working Group, The NHSO Working Group, Secretariat team for the Learning Committee & The Learning Committee 2026, 'The path to safe, equitable and sustainable dialysis provision for people with chronic kidney disease', Nature Medicine, vol. 32, no. 1, pp. 44-46. https://doi.org/10.1038/s41591-025-04144-1

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Nature Medicine Commission on Dialysis Policy in Low- and Middle-Income Countries, Research teams, Secretariat team for the NHSO Working Group, The NHSO Working Group, Secretariat team for the Learning Committee, The Learning Committee. The path to safe, equitable and sustainable dialysis provision for people with chronic kidney disease. Nature Medicine. 2026 Jan;32(1):44-46. doi: 10.1038/s41591-025-04144-1

The path to safe, equitable and sustainable dialysis provision for people with chronic kidney disease

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