Prevention of CKD in Guatemala.

The rapidly growing burden of chronic kidney diseases (CKD) is a major public health problem that will stretch the healthcare system of all countries, especially those not yet industrialized. Guatemala has a population of approximately 14 million, of which 60% are younger than 20 years. It is estimated that only 35% of Guatemalan patients with CKD Stage 5 (ESRD) are diagnosed and treated. Therefore, the cost of death and disability due to CKD in this young population is particularly profound. CKD programs have to compete with many demands (often viewed in the short term as more urgent or widespread) for finite healthcare resources. FUNDANIER (Foundation for Children with Kidney Diseases) has been the instrument that facilitated changes in the Guatemalan health system, in order to establish a comprehensive Pediatric Nephrology program. FUNDANIER is the first local initiative to provide comprehensive prevention and management of kidney disease in children and adolescents in Guatemala. Through an agreement with the National Health Authorities, FUNDANIER is involved in the primary, secondary and tertiary prevention of CKD in the pediatric population. This might be a model applicable in other developing countries.