title: End-stage renal disease and its treatment in Latin America in the twenty-first century.
abstract: The Latin American Society of Nephrology and Arterial Hypertension's Dialysis and Transplant Registry was chartered in 1991. It collects information on ESRD and its treatment in 20 countries of the region. The prevalence of patients on renal replacement therapy (RRT) increased from 129 pmp in 1992 to 447 pmp in 2004; in 2004, 56% of the patients were on hemodialysis, 23% on peritoneal dialysis, and 21% had a functioning kidney graft. The highest rates of prevalence were reported in Puerto Rico (1027 pmp), Chile (686 pmp), and Uruguay (683 pmp). Hemodialysis was widely used, except in El Salvador, Mexico, Guatemala, Nicaragua, and the Dominican Republic, where peritoneal dialysis predominated. Incidence rate increased from 27.8 pmp to 147 pmp in the same period of observation; the lowest rate was reported in Guatemala (11.4 pmp) and the highest in Puerto Rico (337.4 pmp). Diabetes mellitus was the leading cause of renal failure in incident patients; the highest rates were reported in Puerto Rico (62.2%) and Mexico (60%). Forty-four percent of the incident population were older than 65 years. Access to renal replacement therapy was universal in Argentina, Brazil, Chile, Cuba, Puerto Rico, Uruguay, and Venezuela, while was restricted in other countries. Main causes of death in dialysis were cardiovascular (44%) and infectious disease (26%). The rate of renal transplantation increased from 3.7 pmp in 1987 to 14.5 in 2004; fifty-three percent of the organs came from cadavers. Overall, donation rate was 5.9 pmp. In conclusion, the prevalence and incidence rates have increased over the years, and diabetes mellitus has emerged as the leading cause of kidney disease in the region. Although the rate of kidney transplantation has increased, the number remains insufficient to match the growing demand. The implementation of renal health programs in the region is urgently needed.
authors.affiliation: The Latin American Society of Nephrology and Arterial Hypertension's Dialysis and Transplant Registry Committee, Buenos Aires, Argentina.
authors.forename: Ana
authors.initials: A
authors.lastname: Cusumano
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Garcia
authors.forename: Cristina
authors.initials: C
authors.lastname: Di Gioia
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Hermida
authors.forename: Carlos
authors.initials: C
authors.lastname: Lavorato
authors.forename: Cesar Agost
authors.initials: CA
authors.lastname: Carreño
authors.forename: Maria Placida Garron
authors.initials: MP
authors.lastname: Torrico
authors.forename: Paulo Benigno Pena
authors.initials: PB
authors.lastname: Batista
authors.forename: João Egídio
authors.initials: JE
authors.lastname: Romão
authors.forename: Hugo Poblete
authors.initials: HP
authors.lastname: Badal
authors.forename: Susana Elgueta
authors.initials: SE
authors.lastname: Miranda
authors.forename: Rafael
authors.initials: R
authors.lastname: Gomez
authors.forename: Manuel Cerdas
authors.initials: MC
authors.lastname: Calderon
authors.forename: Sergio Herra
authors.initials: SH
authors.lastname: Sanchez
authors.forename: Miguel Almaguer
authors.initials: MA
authors.lastname: Lopez
authors.forename: Julio
authors.initials: J
authors.lastname: Moscoso
authors.forename: Ricardo Leiva
authors.initials: RL
authors.lastname: Merino
authors.forename: Jose Vicente Sánchez
authors.initials: JV
authors.lastname: Polo
authors.forename: Alirio
authors.initials: A
authors.lastname: Lopez
authors.forename: Norman Jiron
authors.initials: NJ
authors.lastname: Romero
authors.forename: Ramiro
authors.initials: R
authors.lastname: Garcia
authors.forename: Blanca V Franco
authors.initials: BV
authors.lastname: Acosta
authors.forename: Augusto Saavedra
authors.initials: AS
authors.lastname: Lopez
authors.forename: Eduardo Santiago
authors.initials: ES
authors.lastname: Delpin
authors.forename: Emilio
authors.initials: E
authors.lastname: Mena
authors.forename: Carlota
authors.initials: C
authors.lastname: González
authors.forename: Carmen Luisa
authors.initials: CL
authors.lastname: Milanés
authors.forename: Sergio
authors.initials: S
authors.lastname: Acchiardo
mesh_terms: D000368:Aged; D017691:Caribbean Region / Q000453:epidemiology; D002489:Central America / Q000453:epidemiology; D006297:Health Services Accessibility; D006436:Hemodialysis Units, Hospital; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation / Q000639:trends; D007843:Latin America / Q000453:epidemiology; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000639:trends; D015995:Prevalence; D012042:Registries; D006435:Renal Dialysis / Q000639:trends; D017582:Renal Replacement Therapy / Q000639:trends*; D013020:South America / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome