Abstract: TH-PO795

Burden of ESKD in Latin America

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Gonzalez-Bedat, Maria Carlota, Latinoamerican Registry of Dialysis and Trasplantation, Montevideo, Uruguay
  • Rosa Diez, Guillermo, Latinoamerican Registry of Dialysis and Trasplantation, Montevideo, Uruguay
  • Ferreiro, Alejandro, Latinoamerican Registry of Dialysis and Trasplantation, Montevideo, Uruguay
  • Luxardo, Rosario, Latinoamerican Registry of Dialysis and Trasplantation, Montevideo, Uruguay

Group or Team Name

  • RLADTR Delegates
Background

End Stage Renal Disease (ESKD) represents a major challenge for Latin America (LA).The strategic plan from the Panamerican Health Association (PAHO) has proposed goal for ESKD in LA: Renal Replacement Therapy (RRT) prevalence of at least 700 patients pmp by 2019. Then, epidemiological information is needed to assist in the development of ESKD care in the region.

Methods

Participant countries completed an annual survey to provide data on incident and prevalent cases of patients undergoing RRT by means of all modalities: Hemodialysis (HD), Peritoneal Dialysis (PD), and trasplantation as well as other relevant parameters. Analyses of these variables were performed to determine correlations with GNI and life expectancy at birth as well as other socioeconomic indexes. For the statistical analysis, the Pearson (r) coefficient was applied, and a p-value < 0.05 was considered significant. The incidence and prevalence of LA RRT rate was compared with USA and Europe.

Results

20 countries participated in the survey, more than 90% of the LA countries. The prevalence of RRT in LA increased from 119 patients pmp in 1991 to 709 pmp in 2014, but only 6 countries have a prevalence above of goal of PAHO. HD continues to be the choice of treatment (90%). The RRT prevalence correlated positively with GNI (r 0.81; p < 0.001) and life expectancy at birth (r 0.56; p < 0.01). A wide incidence rate variation was observed, from 420.9 pmp in Jalisco to 22.6 in Paraguay. When compared with the United States data from 2014, incidence in LA, was substantially lower (157.6 vs 370 respectively), but when compared to the European ERA/EDTA registry (133 pmp) the rate is higher in most LA countries. Diabetes remained the leading cause of ESRD in the region. The most frequent cause of death was cardiovascular. There is a wide rate variation of nephrologists by country.

Conclusion

The heterogeneity or even the absence of registries in some LA countries is congruent with the inequities in access to RRT in such countries, as well as the availability of qualified personnel. The SLANH in cooperation with PAHO, is currently running training programs as well as cooperation programs between LA countries to support less developed ESKD programs. In this spirit, RLADTR is training personnel to carry out dialysis and transplant registries in LA.