Global Dialysis Perspective: Mexico

Abstract

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Dialysis Care around the World: A Global Perspectives Series

“…Mexico has mandated a "peritoneal dialysis first" policy, under which all patients with end-stage kidney disease (with rare exceptions) initiate peritoneal dialysis first, and are only permitted to switch to hemodialysis if peritoneal dialysis fails 19 . This policy has been extremely successful, with 59% of dialysis patients utilizing this modality, resulting in substantial healthcare savings 19 . A similar policy in Guatemala has resulted in 45% of dialysis patients being treated with peritoneal dialysis 7 .…”

“…However, there are several notable exceptions. In Mexico, the average number of hemodialysis treatments per week is 1.2, with only 2% of patients undergoing hemodialysis treatments three times a week 19 . In Guatemala, many patients receive hemodialysis just weekly, with the frequency varying by type of healthcare funding 7 .…”

“…In contrast, Guatemala uses patient-care technicians exclusively 7 . Furthermore, the nursing staff to patient ratio varies markedly from 1:3 in Mexico 19 and Australia 6 to 1:35 in Brazil 17 . The frequency of patient visits by a nephrologist is once monthly in most countries, but is every dialysis session in a few countries (e.g., Korea, Japan, Brazil, and Spain).…”

“…Among those countries with a GNI per capita greater than $40,000, CVC use varies from a high of 59% in Canada 5 to a low of 2% in Japan 9 . Similarly, among countries with a GNP per capita less than $10,000, CVC use varies from a high of 92% in Mexico 19 to a low of 15% in Thailand 12 (Figure 1). Interestingly, the frequency of catheterrelated bloodstream infections is exceptionally low in Canada 5 , despite the very high rate of CVC use.…”

“…The Kidney360 Global Dialysis Perspective series launched in 2020 and showcases how dialysis is practiced, delivered, and financed in different countries across the world. To date, we have featured perspectives from 17 countries in 6 continents: Africa (Senegal, South Africa); Asia (India, Israel, Japan, Korea, Singapore, Thailand, Vietnam); Australia; Europe (Spain); North America (Canada, Mexico, United States); and South America (Argentina, Brazil, Guatemala) [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] . Authors of each global perspective were asked to report standard information about their dialysis populations, including general characteristics of the dialysis system and its treatments such as percentage of patients by dialysis modality; dialysis unit financing (for profit vs. non-profit); reimbursement (public or private insurance, or self-pay); unit location (hospital vs. free standing); staffing (proportion of nurses vs. patient care technicians and nurse to patient ratios); hemodialysis frequency and session length; and frequency of nephrologist visits.…”