The Latin American Dialysis and Renal Transplantation Registry: report 2019

Abstract

Background Chronic kidney disease (CKD) in Latin America (LA) continues to represent a challenge due to the burden of disease it entails and the difficulty in accessing treatment. LA has a total population of 652 million people living in twenty countries that occupy an area of 19.2 million km2.The LA Dialysis and Renal Transplantation Registry (LADRTR), founded in 1991, has collected data and reports on patients receiving kidney replacement therapy (KRT) since 1993.This paper summarizes the registry data corresponding to 2019. Methods Participating countries complete an annual survey collecting aggregated data on incident and prevalent patients on KRT in all modalities. The different treatment modalities considered were hemodialysis (HD), peritoneal dialysis (PD) and living functioning kidney graft (LFG). National gross domestic product per capita (GDP) expressed in US dollars and life expectancy at birth (LEB) corresponding to the year 2019 were collected from the World Bank Data Bank. Prevalence and incidence were compared with previous years and were also correlated with GDP and LEB. Results On 31 December 2019 a total of 432 610 patients were in KRT in LA, corresponding to an overall unadjusted prevalence of 866 pmp. In relation with treatment modality, 66.7% of the prevalent patients were treated by HD and 9.3% by PD while 24% of the patients had a living functional graft. 85 224 patients started KRT in LA, representing a total unadjusted incidence rate of 168 pmp. Diabetic nephropathy as a cause of CKD continues to be a relevant percentage (36%) and five countries reported chronic kidney disease of non-traditional cause. Kidney transplant (KT) rate in the region was 22 pmp, varying from countries with rates close to 1 pmp to greater than 60 pmp. Total prevalence of KRT correlated positively with GDP per capita (r2 = 0.6, p<0.01) and LEB (r2 = 0.23, p<0.05), (Figure 3A and B). Overall incidence rate also significantly correlated with GDP (R2: 0.307 p < 0.05). The overall unadjusted mortality rate was 13%. Conclusion Accessibility to KRT is still limited in LA. It is necessary to continue the efforts made by each country and the Latin American Society of Nephrology and Hypertension to guarantee equal access to treatment.

Censo Brasileiro de Diálise 2021

“…Nossa prevalência de pessoas em diálise (696 pmp) foi ligeiramente superior à média do registro da Sociedade Latino-Americana de Nefrologia (SLAHN) de 2019 (650 pmp) 4 e do registro europeu de 2019 (562 pmp) 5 . Por outro lado, nossos números foram substancialmente inferiores aos dos Estados Unidos em 2019 (1628 pmp) 6 .…”

“…Por outro lado, nossos números foram substancialmente inferiores aos dos Estados Unidos em 2019 (1628 pmp) 6 . A taxa de incidência de 2021 (224 pmp) foi superior à estimativa nacional de 2020 (209 pmp), superior às taxas da América Latina (168 pmp) 4 e Europa (125 pmp) em 2019 5 , e inferior à taxa dos Estados Unidos (392 pmp) em 2019 6 .…”

“…Embora quase metade dos centros participantes ofereçam a DP como opção de tratamento (48%), apenas 5,8% dos pacientes em diálise eram tratados por esta modalidade. A prevalência atual nos países da América Latina é de 14% 4 . Houve um aumento significativo na predominância de diálise peritoneal automatizada (DPA) em relação aos dois anos anteriores (85% versus ~60%), seguindo uma tendência observada em países desenvolvidos 10 .…”

Situación de la enfermedad renal crónica en Colombia

“…Según el último reporte del Registro Latinoamericano de Diálisis y Trasplante, en América Latina hay en promedio 19 nefrólogos PMP. En Colombia se reportaron ocho nefrólogos PMP, teniendo un numero de nefrólogos por debajo del promedio de la región 6 . La gran mayoría de nefrólogos en Colombia están concentrados en las cuatro principales ciudades del país: Bogotá, Medellín, Cali y Barranquilla.…”

Precision medicine implementation challenges for APOL1 testing in chronic kidney disease in admixed populations

“…In Europe, the prevalence of ESRD has been estimated to be 801 patients per million (Kramer et al, 2018), while in the United States of America, it reached 2,242 cases per million in 2018 (United States Renal Data System (USRDS), 2020). In Latin America and the Caribbean, overall CKD prevalence has been estimated at 10% (Sequeiros-Buendia et al, 2021), although the prevalence rates vary among countries (Cusumano and Bedat, 2008;Luxardo et al, 2022).…”