Division of Nephrology, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico.
Semin Nephrol. 2010 Jan;30(1):3-7. doi: 10.1016/j.semnephrol.2009.10.001.
End-stage renal disease represents a serious public health problem in Mexico. Close to 9% of the Mexican population has chronic kidney disease (CKD) and 40,000 patients are on dialysis. However, the fragmentation of our health care system has resulted in unequal access to renal replacement therapy. In addition, poor patients in Jalisco with kidney failure have very advanced disease at the time of dialysis initiation, suggesting lack of access to predialysis care. To address these issues, a number of strategies have been implemented. Among them a renal replacement therapy program for which the cost of treatment is shared by government, patients, industry, and charitable organizations; the implementation of a state-funded hemodialysis program that provides free dialysis for the poor; the establishment of a university-sponsored residency program in nephrology and a postgraduate training in nephrology nursing; and a screening program for early detection and control of CKD. In conclusion, access to renal care is unequal. The extension of the Seguro Popular to cover end-stage renal disease treatment nationwide and the implementation of community screening programs for the detection and control of CKD offers an opportunity to correct the existing disparities in renal care in Jalisco and perhaps in other regions of Mexico.
终末期肾病是墨西哥面临的一个严重公共卫生问题。近 9%的墨西哥人口患有慢性肾脏病（CKD），有 4 万名患者正在接受透析。然而，由于医疗保健系统碎片化，导致肾替代治疗的可及性不平等。此外，在哈利斯科州患有肾衰竭的贫困患者在开始透析时病情已经非常严重，这表明他们无法获得透析前的护理。为了解决这些问题，已经实施了一些策略。其中包括一项肾替代治疗方案，该方案的治疗费用由政府、患者、行业和慈善组织共同承担；实施了一项由州政府资助的血液透析计划，为贫困人群提供免费透析；建立了一个由大学赞助的肾病学居住项目和一个肾病学护理研究生培训项目；以及一项针对 CKD 的早期发现和控制的筛查计划。总之，肾护理的可及性不平等。将 Seguro Popular 扩大到覆盖全国范围内的终末期肾病治疗，以及实施社区筛查计划以发现和控制 CKD，为纠正哈利斯科州乃至墨西哥其他地区现有的肾脏护理差距提供了机会。
