Almaguer Miguel, Herrera Raul, Alfonzo Jorge, Magrans Charles, Mañalich Reynaldo, Martinez Atilano, Davalos Jose, Perez-Oliva Jorge, Landrove Orlando
Institute of Nephrology, Department of Preventive Nephrology, Ave. 26 y Boyeros Plaza, Havana, Cuba.
Ren Fail. 2006;28(8):671-6. doi: 10.1080/08860220600925768.
The experience of the Republic of Cuba regarding epidemiological studies, integral medical care, and strategies for the prevention of chronic kidney disease is summarized in this report. Cuba has a National Program for Chronic Renal Disease, Dialysis, and Renal Transplantation. There is a national nephrology net, integrated by the Institute of Nephrology as the coordinator center, that has 47 nephrology services with a hemodialysis unit (24 of them with peritoneal dialysis unit), 9 transplantation centers, 33 organ procurement hospitals, and 5 histocompatibility laboratories. In 2004, the incidence rate in dialysis patients was 111 pmp, and the prevalence rate was 149 pmp, demonstrating an increasing mean of 17.0% and 10.0% per year, respectively. Renal transplantation rate was 16.6 pmp. The detection, registration, and follow-up of patients with chronic kidney disease (serum creatinine > or =1.5 mg/dL or glomerular filtration rate <60 mL/min) by family doctors was 9,761 patients, 0.87 patients per 1,000 inhabitants. In the 1980s, three population-based screening studies were performed to define the burden of chronic renal failure in different regions of Cuba. The prevalence rate was 1.1, 3.3, and 3.5 per 1,000 inhabitants, respectively. At present, another three population-based screening studies are ongoing in order to detect the chronic kidney disease in earliest stages. The continuing medical education activities have been very useful in raising the awareness of medical doctors and the basic health staff about the threats posed by and the strategies to prevent, diagnose, and treat chronic kidney disease.
本报告总结了古巴共和国在流行病学研究、综合医疗护理以及慢性肾脏病预防策略方面的经验。古巴有一项慢性肾脏病、透析及肾移植国家计划。该国存在一个全国肾脏病网络，由肾脏病研究所作为协调中心，该网络有47个配备血液透析单元的肾脏病服务机构（其中24个还设有腹膜透析单元）、9个移植中心、33个器官获取医院以及5个组织相容性实验室。2004年，透析患者的发病率为每百万人口111例，患病率为每百万人口149例，分别显示出年均增长17.0%和10.0%。肾移植率为每百万人口16.6例。家庭医生对慢性肾脏病患者（血清肌酐≥1.5 mg/dL或肾小球滤过率<60 mL/分钟）的检测、登记及随访患者有9761例，即每1000名居民中有0.87例。在20世纪80年代，开展了三项基于人群的筛查研究，以确定古巴不同地区慢性肾衰竭的负担。患病率分别为每1000名居民1.1例、3.3例和3.5例。目前，另外三项基于人群的筛查研究正在进行，以便在最早阶段检测出慢性肾脏病。继续医学教育活动对于提高医生和基层卫生人员对慢性肾脏病所构成威胁以及预防、诊断和治疗策略的认识非常有用。
