国际肾脏病学会拉丁美洲地区肾衰竭管理能力:2023 年 ISN 全球肾脏健康地图集(ISN-GKHA)报告

IF 19.3 2区 医学 Q1 UROLOGY & NEPHROLOGY Kidney International Supplements Pub Date : 2024-04-01 DOI:10.1016/j.kisu.2024.01.001
Viviane Calice-Silva , Javier A. Neyra , Alejandro Ferreiro Fuentes , Krissia Kamile Singer Wallbach Massai , Silvia Arruebo , Aminu K. Bello , Fergus J. Caskey , Sandrine Damster , Jo-Ann Donner , Vivekanand Jha , David W. Johnson , Adeera Levin , Charu Malik , Masaomi Nangaku , Ikechi G. Okpechi , Marcello Tonelli , Feng Ye , Magdalena Madero , Carmen Tzanno Martins , Deenaz Zaidi
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引用次数: 0

摘要

在拉丁美洲(LA),慢性肾脏病(CKD)的成功治疗仍然是一项挑战,原因是疾病负担沉重、地域差异以及肾衰竭治疗能力、可及性、公平性和质量方面的困难。尽管在过去几十年中,拉丁美洲经历了重大的社会和经济进步,但在医疗服务方面仍然存在严重的不平等。通过国际肾脏病学会全球肾脏健康地图集的第三次迭代,有关洛杉矶肾衰竭护理的指标得到了更新。在洛杉矶的 31 个国家中,有 22 个国家(71%)对调查做出了回复,占总人口的 96.5%。中位数 CKD 患病率为 10.2%(四分位数间距:8.4%-12.3%),中位数 CKD 残疾调整生命年为 753.4 天(四分位数间距:581.3-1072.5 天),中位数 CKD 死亡率为 5.5%(四分位数间距:3.2%-6.3%)。在透析方式方面,血液透析仍然是最常用的疗法,而腹膜透析在过去 10 年中达到了高峰,肾移植则稳步增加。在 20 个国家(占 91%)中,50% 的肾衰竭患者可以接受透析治疗,只有 2 个国家(占 9%)的透析患者可以通过腹膜透析开始透析治疗。公共和私营系统共同资助肾脏替代疗法(透析和移植)的大多数方面,许多人自付费用高达 50%。很少有洛杉矶国家建立了慢性肾脏病/肾脏替代疗法登记处,几乎没有急性肾损伤登记处的报告。在洛杉矶,肾衰竭护理的性质和程度存在很大差异,这主要与各国的供资结构以及有限的监测和管理举措有关。
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Capacity for the management of kidney failure in the International Society of Nephrology Latin America region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)

Successful management of chronic kidney disease (CKD) in Latin America (LA) continues to represent a challenge due to high disease burden and geographic disparities and difficulties in terms of capacity, accessibility, equity, and quality of kidney failure care. Although LA has experienced significant social and economic progress over the past decades, there are still important inequities in health care access. Through this third iteration of the International Society of Nephrology Global Kidney Health Atlas, the indicators regarding kidney failure care in LA are updated. Survey responses were received from 22 of 31 (71%) countries in LA representing 96.5% of its total population. Median CKD prevalence was 10.2% (interquartile range: 8.4%–12.3%), median CKD disability-adjusted life year was 753.4 days (interquartile range: 581.3–1072.5 days), and median CKD mortality was 5.5% (interquartile range: 3.2%–6.3%). Regarding dialysis modality, hemodialysis continued to be the most used therapy, whereas peritoneal dialysis reached a plateau and kidney transplantation increased steadily over the past 10 years. In 20 (91%) countries, >50% of people with kidney failure could access dialysis, and in only 2 (9%) countries, people who had access to dialysis could initiate dialysis with peritoneal dialysis. A mix of public and private systems collectively funded most aspects of kidney replacement therapy (dialysis and transplantation) with many people incurring up to 50% of out-of-pocket costs. Few LA countries had CKD/kidney replacement therapy registries, and almost no acute kidney injury registries were reported. There was large variability in the nature and extent of kidney failure care in LA mainly related to countries’ funding structures and limited surveillance and management initiatives.

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来源期刊
Kidney International Supplements
Kidney International Supplements UROLOGY & NEPHROLOGY-
CiteScore
11.80
自引率
0.00%
发文量
13
期刊介绍: Kidney International Supplements is published on behalf of the International Society of Nephrology (ISN) and comes complimentary as part of a subscription to Kidney International. Kidney International Supplements is a peer-reviewed journal whose focus is sponsored, topical content of interest to the nephrology community.
期刊最新文献
Editorial Board Table of Contents Variations in kidney care management and access: regional assessments of the 2023 International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) Update on variability in organization and structures of kidney care across world regions Capacity for the management of kidney failure in the International Society of Nephrology Newly Independent States and Russia region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)
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