Luxardo Rosario, Ceretta Laura, González-Bedat María, Ferreiro Alejandro, Rosa-Diez Guillermo
Latin American Dialysis and Renal Transplantation Registry, Montevideo, Uruguay.
Clin Kidney J. 2021 Oct 12;15(3):425-431. doi: 10.1093/ckj/sfab188. eCollection 2022 Mar.
Chronic kidney disease (CKD) in Latin America (LA) continues to represent a challenge due to the burden of disease it causes and the difficulty in accessing treatment. LA has a total population of 652 million people living in 20 countries that occupy an area of 19.2 million km. The Latin American Dialysis and Renal Transplantation Registry (LADRTR), founded in 1991, has collected data and reports on patients receiving kidney replacement therapy (KRT) since 1993. This article summarizes the registry data for 2019.
Participating countries complete an annual survey collecting aggregated data on incident and prevalent patients on KRT in all modalities. The different treatment modalities considered were hemodialysis (HD), peritoneal dialysis (PD) and living functioning kidney graft (LFG). National gross domestic product per capita (GDP, expressed in US dollars) and life expectancy at birth (LEB) corresponding to the year 2019 were collected from the World Bank Data Bank. Prevalence and incidence were compared with previous years and were also correlated with GDP and LEB.
On 31 December 2019 a total of 432 610 patients were in KRT in LA, corresponding to an overall unadjusted prevalence of 866 per million population (pmp). Regarding treatment modality, 66.7% of the prevalent patients were treated with HD and 9.3% with PD while 24% of the patients had an LFG. A total of 85 224 patients started KRT in LA, representing a total unadjusted incidence rate of 168 pmp. Diabetic nephropathy as a cause of CKD continues to be a relevant percentage (36%) and five countries reported CKD of nontraditional causes. The kidney transplant rate in the region was 22 pmp, varying from 1 to >60 pmp. The total prevalence of KRT correlated positively with GDP per capita ( = 0.6, P < 0.01) and LEB ( = 0.23, P < 0.05). The overall incidence rate also significantly correlated with GDP ( = 0.307, P < 0.05). The overall unadjusted mortality rate was 13%.
Accessibility to KRT is still limited in LA. It is necessary to continue the efforts made by each country and the Latin American Society of Nephrology and Hypertension to guarantee equal access to treatment.
由于慢性肾脏病（CKD）所造成的疾病负担以及获得治疗的困难，拉丁美洲（LA）的慢性肾脏病仍然是一项挑战。拉丁美洲有6.52亿人口，分布在20个国家，面积为1920万平方公里。成立于1991年的拉丁美洲透析与肾移植登记处（LADRTR）自1993年以来一直在收集接受肾脏替代治疗（KRT）患者的数据并进行报告。本文总结了2019年的登记数据。
参与国家完成年度调查，收集所有治疗方式下新发病例和现患病例的汇总数据。所考虑的不同治疗方式包括血液透析（HD）、腹膜透析（PD）和活体功能肾移植（LFG）。从世界银行数据库收集了2019年各国的人均国内生产总值（GDP，以美元表示）和出生时预期寿命（LEB）。将患病率和发病率与前几年进行比较，并与GDP和LEB进行相关性分析。
2019年12月31日，拉丁美洲共有432610例患者接受肾脏替代治疗，总体未调整患病率为每百万人口866例（pmp）。关于治疗方式，66.7%的现患患者接受血液透析治疗，9.3%接受腹膜透析治疗，24%的患者接受活体功能肾移植。拉丁美洲共有85224例患者开始接受肾脏替代治疗，总体未调整发病率为168 pmp。糖尿病肾病作为慢性肾脏病的病因仍然占相当比例（36%），有五个国家报告了非传统病因的慢性肾脏病。该地区的肾移植率为22 pmp，从1到>60 pmp不等。肾脏替代治疗的总患病率与人均GDP呈正相关（r = 0.6，P < 0.01），与出生时预期寿命呈正相关（r = 0.23，P < 0.05）。总体发病率也与GDP显著相关（r = 0.307，P < 0.05）。总体未调整死亡率为13%。
在拉丁美洲，获得肾脏替代治疗的机会仍然有限。每个国家以及拉丁美洲肾脏病与高血压学会有必要继续努力，以确保平等获得治疗的机会。
