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首页> 外文期刊>Clinical kidney journal. >Renal replacement therapy in Latin American end-stage renal disease
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Renal replacement therapy in Latin American end-stage renal disease

机译：拉丁美洲终末期肾脏疾病的肾脏替代治疗

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The Latin American Dialysis and Renal Transplant Registry (RLADTR) was founded in 1991; it collects data from 20 countries which are members of Sociedad Latinoamericana de Nefrología e Hipertension. This paper presents the results corresponding to the year 2010. This study is an annual survey requesting data on incident and prevalent patients undergoing renal replacement treatment (RRT) in all modalities: hemodialysis (HD), peritoneal dialysis (PD) and living with a functioning graft (LFG), etc. Prevalence and incidence were compared with previous years. The type of renal replacement therapy was analyzed, with special emphasis on PD and transplant (Tx). These variables were correlated with the gross national income (GNI) and the life expectancy at birth. Twenty countries participed in the surveys, covering 99% of the Latin American. The prevalence of end stage renal disease (ESRD) under RRT in Latin America (LA) increased from 119 patients per million population (pmp) in 1991 to 660 pmp in 2010 (HD 413 pmp, PD 135 pmp and LFG 111 pmp). HD proportionally increased more than PD, and Tx HD continues to be the treatment of choice in the region (75%). The kidney Tx rate increased from 3.7 pmp in 1987 to 6.9 pmp in 1991 and to 19.1 in 2010. The total number of Tx's in 2010 was 10 397, with 58% deceased donors. The total RRT prevalence correlated positively with GNI (r2 0.86; P 0.05) and life expectancy at birth (r2 0.58; P 0.05). The HD prevalence and the kidney Tx rate correlated significantly with the same indexes, whereas the PD rate showed no correlation with these variables. A tendency to rate stabilization/little growth was reported in the most regional countries. As in previous reports, the global incidence rate correlated significantly only with GNI (r2 0.63; P 0.05). Diabetes remained the leading cause of ESRD. The most frequent causes of death were cardiovascular (45%) and infections (22%). Neoplasms accounted for 10% of the causes of death. The prevalence of RRT continues to increase, particularly in countries with 100% public health or insurance coverage for RRT, where it approaches rates comparable to those displayed by developed countries with a better GNI. The incidence also continues to increase in both countries that have not yet extended its coverage to 100% of the population as well as in those that have an adequate program for timely detection and treatment of chronic kidney disease (CKD) and its associated risk factors. PD is still an underutilized strategy for RRT in the region. Even though renal Tx is feasible, its growth rate is still not as fast as it should be in order to compensate for the increased prevalence of patients on waiting lists. 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. Regional cooperation among Latin American countries, allowing the more developed to guide and train others in starting registries and CKD programs, may be one of the key initiatives to address this deficit.
机译：拉丁美洲透析和肾脏移植注册机构（RLADTR）成立于1991年;它收集了来自Sociedad Latinoamericana deNefrologíae Hipertension的20个国家/地区的数据。本文介绍了与2010年相对应的结果。这项研究是一项年度调查，要求就所有方式（血液透析（HD），腹膜透析（PD）和功能正常的患者）接受肾替代治疗（RRT）的事件和普遍患者的数据移植物（LFG）等的患病率和发病率与往年进行了比较。分析了肾脏替代疗法的类型，特别是PD和移植（Tx）。这些变量与国民总收入（GNI）和出生时的预期寿命相关。二十个国家参加了调查，覆盖了拉丁美洲的99％。拉丁美洲（LA）接受RRT治疗的末期肾病（ESRD）患病率从1991年的每百万人口119名患者（pmp）增加到2010年的660 pmp（HD 413 pmp，PD 135 pmp和LFG 111 pmp）。 HD的比例增幅大于PD，Tx HD仍是该区域的首选治疗方法（75％）。肾脏Tx速率从1987年的3.7 pmp增加到1991年的6.9 pmp，到2010年的19.1。在2010年，Tx总数为10 397，死者为58％。总RRT患病率与GNI（r 2 0.86; P <0.05）和出生时的预期寿命（r 2 0.58; P <0.05）正相关。 HD患病率和肾脏Tx率与相同指标显着相关，而PD率与这些变量无相关性。据报告，大多数区域国家都有稳定/小幅增长的趋势。如以前的报告所述，全球发生率仅与GNI显着相关（r 2 0.63; P <0.05）。糖尿病仍然是ESRD的主要原因。死亡的最常见原因是心血管（45％）和感染（22％）。肿瘤占死亡原因的10％。 RRT的患病率持续上升，特别是在公共卫生或RRT保险覆盖率达到100％的国家，其比率接近于GNI较高的发达国家所显示的比率。在尚未将其覆盖范围扩大到100％人口的两个国家，以及已经制定了及时检测和治疗慢性肾脏病（CKD）及其相关危险因素的适当计划的国家，发病率也继续增加。局部数据仍然是该地区RRT使用不足的策略。尽管肾脏Tx是可行的，但其增长速度仍不如应有的快，以补偿等待名单上患者的患病率增加。该地区需要高血压和糖尿病的诊断和预防计划，促进PD扩大和器官采购的适当政策，以及具有成本效益的RRT形式的移植。拉丁美洲国家之间的区域合作可以使较发达的国家在开始注册管理机构和CKD计划方面指导和培训其他国家，这可能是解决这一赤字的关键举措之一。

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