Escamilla-Cejudo José Antonio, Báez Jorge Lara, Peña Rodolfo, Luna Patricia Lorena Ruiz, Ordunez Pedro
Organización Panamericana de la Salud (OPS), Washington D.C., Estados Unidos de América.
Centro Colaborador para la Familia de Clasificaciones Internacionales de la Organización Mundial de la Salud (CEMECE), México D.F., México.
Rev Panam Salud Publica. 2016 Nov;40(5):285-293.
Several Central American countries are seeing continued growth in the number of deaths from chronic kidney disease of nontraditional causes (CKDnT) among farm workers and there is underreporting. This report presents the results of a consensus process coordinated by the Pan American Health Organization/World Health Organization (PAHO/WHO), the United States Centers for Disease Control and Prevention (CDC), and the Latin American Society of Nephrology and Hypertension (SLANH). This consensus seeks to increase the probability of detecting and recording deaths from these causes. There has been recognition of the negative impact of the lack of a standardized instrument and the lack of training in the medical profession for adequate registration of the cause or causes of death. As a result of the consensus, the following has been proposed: temporarily use a code from the Codes for Special Purposes in the International Classification of Diseases (ICD-10); continue to promote use of the WHO international standardized instrument for recording causes and preceding events related to death; increase training of physicians responsible for filling out death certificates; take action to increase the coverage and quality of information on mortality; and create a decision tree to facilitate selection of CKDnT as a specific cause of death, while presenting the role that different regional and subregional mechanisms in the Region of the Americas should play in order to improve CKD and CKDnT mortality records.
几个中美洲国家的农场工人因非传统病因慢性肾脏病（CKDnT）导致的死亡人数持续增长，且存在报告不足的情况。本报告展示了由泛美卫生组织/世界卫生组织（PAHO/WHO）、美国疾病控制与预防中心（CDC）以及拉丁美洲肾脏病与高血压学会（SLANH）共同协调的一项共识进程的结果。这一共识旨在提高检测和记录这些病因导致的死亡的可能性。人们已经认识到缺乏标准化工具以及医学专业缺乏关于充分登记死亡原因的培训所带来的负面影响。基于这一共识，提出了以下建议：暂时使用《国际疾病分类》（ICD - 10）中特殊用途编码；继续推广使用世卫组织用于记录与死亡相关的原因及先前事件的国际标准化工具；加强对负责填写死亡证明的医生的培训；采取行动提高死亡率信息的覆盖范围和质量；创建一个决策树，以方便将CKDnT选为特定死亡原因，同时展示美洲区域不同区域和次区域机制在改善CKD和CKDnT死亡率记录方面应发挥的作用。
