Latin American Dialysis and Transplant Registry: 2008 prevalence and incidence of end-stage renal disease and correlation with socioeconomic indexes

Abstract

In 2008, 563,294,000 people were living in Latin America (LA), of which 6.6% were older than 65. The region is going through a fast demographic and epidemiologic transition process, in the context of an improvement in socio-economic indices. The Latin American Dialysis and Renal Transplant Registry has collected data since 1991, through an annual survey completed by 20 affiliated National Societies. Renal replacement treatment (RRT) prevalence and incidence showed an increase year by year. The prevalence rate (in all modalities) correlated with the World Bank country classification by income and the epidemiologic transition stage the countries were experiencing. RRT prevalence and kidney transplantation rates correlated significantly with gross national income (GNI), health expenditure in constant dollars (HeExp), % older than 65, life expectancy at birth, and % of the population living in urban settings. Kidney transplantation increased also, year by year, with more than 50% of transplants performed using kidneys from deceased donors. Double transplants were performed in six countries. RRT prevalence and incidence increased in LA, and are associated with indexes reflecting higher and more evenly distributed national wealth (GNI and HeExp), and the stage of demographic and epidemiological transition.

Prevalência de doença renal crônica em adultos no Brasil: revisão sistemática da literatura

“…O número de pacientes em terapia dialítica na América Latina tem aumentado nos últimos anos, o que pode estar associado às dificuldades de acesso ao tratamento 2,13,47,48 . Dados sobre estágios iniciais permanecem indisponíveis ou pouco explorados nestes países 48 , possivelmente devido à falta de diagnóstico precoce.…”

Chronic kidney disease in disadvantaged populations

“…Access to RRT in the emerging world is dependent mostly on the healthcare expenditures and economic strength of individual countries, with the relationship between income and access to RRT being almost linear in low-and middleincome countries [19,35]. In Latin America, RRT prevalence and kidney transplantation rates correlate significantly with gross national income and health expenditure [36], while in India and Pakistan, less than 10 % of all ESRD patients have access to RRT [37]. Additionally, developing countries have low transplant rates because of a combination of low levels of infrastructure, geographical remoteness, lack of legislation governing brain death, religious, cultural, and social constraints, and commercial incentives that favor dialysis [38].…”

CKD in Disadvantaged Populations

“…In Latin America, RRT prevalence and kidney transplantation rates correlate significantly with gross national income and health expenditure [37], while in India and Pakistan, less than 10% of all ESRD patients have access to RRT [38]. Additionally, developing countries have low transplant rates because of a combination of low levels of infrastructure; geographical remoteness; lack of legislation governing brain death; religious, cultural and social constraints; and commercial incentives that favour dialysis [39].…”