Rosa-Diez Guillermo
University of Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Registro Argentino de Diálisis Crónica, Instituto Nacional Central Único Coordinador de Ablación e Implante, Sociedad Argentina de Nefrología, Buenos Aires, Argentina; Latin America Dialysis and Renal Transplantation Registry, Sociedad Latinoamericana de Nefrología e Hipertensión, Panamá City, Panamá.
Semin Nephrol. 2025 Jan-Mar;45(1-2):151603. doi: 10.1016/j.semnephrol.2025.151603. Epub 2025 May 7.
The third major subgroup requiring admission to dialysis in Argentina are individuals with kidney failure without a known cause, also known as chronic kidney disease of unknown origin (CKDUO). In this retrospective cohort study, the characteristics of this group were described using data from the National Dialysis and Transplant Registry. In Argentina, 113,352 patients commenced maintenance dialysis from April 1, 2004, to December 31, 2021 (213 months); 42% of patients were older than 65 years of age and 2.3% were younger than 18 years of age. There was a predominance of male patients (66,650 [58.8%]) and 6% were foreigners (6,688). Only 9.4% of patients (10,655) had a diagnosis confirmed by a kidney biopsy. The most common causes of kidney disease requiring dialysis admission were diabetic nephropathy (36%), hypertensive nephropathy (21%), and CKDUO (17%). The most frequent dialysis modality was hemodialysis and the majority were admitted with temporary vascular access. Mean survival time from the initiation of dialysis was 44.8 months, with 59.2 months (95% confidence interval, 58.0-60.4) for patients with CKDUO versus 48.6 months (95% confidence interval, 48.2-49.0) for others. Patients with CKDUO were younger and more frequently female, with fewer comorbidities, more precarious socioeconomic status, and indicators of late or absent renal health assistance. There was a heterogeneous renal biopsy rate by state related to the accessibility of diagnostic tools. Health policy and health actions are required to allow kidney health accessibility in earlier stages of chronic kidney disease.
在阿根廷，需要接受透析治疗的第三大主要亚组是病因不明的肾衰竭患者，也被称为不明原因慢性肾脏病（CKDUO）。在这项回顾性队列研究中，利用国家透析和移植登记处的数据描述了该组患者的特征。在阿根廷，从2004年4月1日至2021年12月31日（213个月），有113352例患者开始接受维持性透析治疗；42%的患者年龄超过65岁，2.3%的患者年龄小于18岁。男性患者占多数（66650例[58.8%]），6%为外国人（6688例）。只有9.4%的患者（10655例）通过肾活检确诊。需要透析治疗的肾脏疾病最常见的病因是糖尿病肾病（36%）、高血压肾病（21%）和CKDUO（17%）。最常用的透析方式是血液透析，大多数患者通过临时血管通路入院。从开始透析起的平均生存时间为44.8个月，CKDUO患者为59.2个月（95%置信区间，58.0 - 60.4），其他患者为48.6个月（95%置信区间，48.2 - 49.0）。CKDUO患者更年轻，女性更常见，合并症更少，社会经济状况更不稳定，且肾脏健康援助较晚或缺乏。不同州的肾活检率存在差异，这与诊断工具的可及性有关。需要卫生政策和卫生行动，以使慢性肾脏病早期阶段的肾脏健康能够得到保障。
