Burden of disease: prevalence and incidence of ESRD in Latin America.
BACKGROUND
Chronic kidney disease (CKD) represents a major challenge for Latin America (LA), due to its epidemic proportions and high burden to the population affected and to public health systems.


METHODS
Our methods have been reported previously: This paper shows the data for the last 10 years until 2010, from the Latin American Dialysis and Renal Transplantation Registry (RLADTR).


RESULTS
20 countries participated in the surveys, covering 99% of Latin America (LA). The prevalence of end-stage renal disease (ESRD) under renal replacement therapy (RRT) in LA increased from 119 patients per million population (pmp) in 1991 to 660 pmp in 2010 (hemodialysis (HD) 413 pmp, peritoneal dialysis (PD) 135 pmp, and LFG 111 pmp). HD proportionally increased more than PD and transplant and continues to be the treatment of choice in the region (75%). The kidney transplant rate increased from 3.7 pmp in 1987 to 6.9 pmp in 1991 and to 19.1 in 2010. The total number of transplants in 2010 was 10,397, with 58% being deceased donors. The total RRT prevalence correlated positively with gross national income (GNI) (r = 0.86; p < 0.05) and life expectancy at birth (r = 0.58; p < 0.05). The global incidence rate correlated significantly only with GNI (r = 0.56; p < 0.05). Diabetes remained the leading cause of ESRD.


CONCLUSIONS
The prevalence and incidence of RRT continues to increase. In countries with 100% public health or insurance coverage for RRT the rates are comparable to those displayed by developed countries with better GNI. PD is still an underutilized strategy for RRT in the region. Diagnostic and prevention programs for hypertension and diabetes, appropriate policies promoting the expansion of PD and organ procurement as well as transplantation as cost effective forms of RRT are needed in the region.
Executive Board of the Latin American Dialysis and Transplant Registry (LADTR), and Latin American Dialysis and Transplant Society (SLANH).
Marta
M
Gonzalez-Bedat
Guillermo
G
Rosa-Diez
Roberto
R
Pecoits-Filho
Alejandro
A
Ferreiro
Guillermo
G
García-García
Ana
A
Cusumano
Juan
J
Fernandez-Cean
Oscar
O
Noboa
Walter
W
Douthat
D017281:Cost of Illness; D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000453:epidemiology*; D007843:Latin America / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies