Cusumano Ana, Garcia Garcia Guillermo, Gonzalez Bedat Carlota
Latin American Transplantation Registry.
Ethn Dis. 2009 Spring;19(1 Suppl 1):S1-3-6.
The Latin American Dialysis and Transplant Registry collects information on end-stage renal disease and its treatment in 20 countries of the region. By December 2005, a total of 257,974 patients were on renal replacement therapy, for a prevalence of 478.2 cases per million population; 57% were on hemodialysis, 23% on peritoneal dialysis, and 20% had a functioning kidney graft. The prevalence on renal replacement therapy continued to grow at a rate of approximately 6% annually. Hemodialysis continued to be the treatment of choice in the region, except for in Mexico, Nicaragua, El Salvador, the Dominican Republic, and Guatemala, where peritoneal dialysis predominated. Diabetes remained the leading cause of end-stage renal disease, and the highest incidences were reported in Puerto Rico (65%), Mexico (51%), Venezuela (42%), and Colombia (35%). Forty-four percent of incident patients were aged > 65 years. The rate of transplantation remained unchanged at 15 per million population, which is not sufficient to satisfy the demand of the growing number of patients in the waiting list. Close to 50% of transplants came from cadaver donors. A total of 137 simultaneous kidney-pancreas transplants were performed, 123 in Brazil, 6 in Argentina, 3 in Uruguay, 2 each in Colombia and Mexico, and 1 in Chile. In addition, 1 cardiorenal transplant (Argentina) and 1 liver-renal transplant (Chile) were reported. In conclusion, the incidence and prevalence of renal replacement therapy continued to grow. Prevention of chronic kidney disease and an integrated approach of affordable dialysis and transplantation are urgently needed in the region.
拉丁美洲透析与移植登记处收集了该地区20个国家终末期肾病及其治疗的相关信息。截至2005年12月,共有257,974名患者接受肾脏替代治疗,每百万人口患病率为478.2例;57%接受血液透析,23%接受腹膜透析,20%拥有功能正常的肾移植。肾脏替代治疗的患病率继续以每年约6%的速度增长。除墨西哥、尼加拉瓜、萨尔瓦多、多米尼加共和国和危地马拉以腹膜透析为主外,血液透析仍是该地区的首选治疗方式。糖尿病仍然是终末期肾病的主要病因,波多黎各(65%)、墨西哥(51%)、委内瑞拉(42%)和哥伦比亚(35%)的发病率最高。44%的新发病例年龄>65岁。移植率维持在每百万人口15例不变,这不足以满足等待名单上不断增加的患者需求。近50%的移植来自尸体供体。共进行了137例同时肾胰联合移植,其中巴西123例,阿根廷6例,乌拉圭3例,哥伦比亚和墨西哥各2例,智利1例。此外,还报告了1例心肾联合移植(阿根廷)和1例肝肾联合移植(智利)。总之,肾脏替代治疗的发病率和患病率持续上升。该地区迫切需要预防慢性肾病以及采取综合方法提供可负担得起的透析和移植服务。