Current status of renal replacement therapy in Cuba 2006.

We present the main structural and organizational features, as well as the human resources and the activities of Cuba in nephrology, dialysis, and transplantation. Access to renal replacement therapy is universal (not restricted). There are 47 hemodialysis services. There are 281 renal physicians (216 serving adult patients and 65 pediatric nephrologists). The incidence of renal replacement rose from 71 per million population (pmp) in 2000 to 98 pmp in 2006. The prevalence of patients on dialysis treatment increased from 100 pmp in 2000 to 194 pmp in 2006. Growth rates for dialysis increased by an average of 10.6% annually in this time. The overall prevalence of patients increased from 156 pmp in 1999 to 275 pmp in 2006. The main cause of endstage renal disease was diabetes mellitus. Main causes of death on dialysis were cardiovascular disease (43.7%) and infectious disease (22.8%). Ninety percent of the organs were retrieved from cadavers. The cadaveric donation rate was 10 pmp. Cuba shares economic limitations with its neighbors but is one of the emerging world's least socially stratified countries, with a universal, free public healthcare system emphasizing primary health care and prevention in nephrology.