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World J Nephrol. Sep 6, 2016; 5(5): 389-397
Published online Sep 6, 2016. doi: 10.5527/wjn.v5.i5.389
Latin American Dialysis and Transplant Registry: Experience and contributions to end-stage renal disease epidemiology
Ana Maria Cusumano, Guillermo Javier Rosa-Diez, Maria Carlota Gonzalez-Bedat
Ana Maria Cusumano, CEMIC University Institute School of Medicine, Buenos Aires, PC C1430EFA, Argentina
Guillermo Javier Rosa-Diez, Nephrology Service, Italian Hospital, Buenos Aires City, PC C1199ABC, Argentina
Maria Carlota Gonzalez-Bedat, Latin American Society of Nephrology and Hypertension, Montevideo City, PC 11600, Uruguay
Author contributions: Cusumano AM, Rosa-Diez GJ and Gonzalez-Bedat MC contributed equally to the conception and design of the study, collecting and analyzing the data, writing and critically revising the manuscript, and approving the final version.
Conflict-of-interest statement: The authors declare they have no conflicts of interests regarding this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ana Maria Cusumano, MD, PhD, CEMIC University Institute School of Medicine, Valdenegro 4337, Buenos Aires, PC C1430EFA, Argentina. anacusumano@yahoo.com.ar
Telephone: +54-11-52990914
Received: April 29, 2016
Peer-review started: May 3, 2016
First decision: June 17, 2016
Revised: July 29, 2016
Accepted: August 17, 2016
Article in press: August 18, 2016
Published online: September 6, 2016
Processing time: 125 Days and 1.4 Hours
Abstract

In 2015, 634387 million people (9% of the world’s population) resided in Latin America (LA), with half of those populating Brazil and Mexico. The LA Dialysis and Transplant Registry was initiated in 1991, with the aim of collecting data on renal replacement therapy (RRT) from the 20 LA-affiliated countries. Since then, the Registry has revealed a trend of increasing prevalence and incidence of end-stage kidney disease on RRT, which is ongoing and is correlated with gross national income, life expectancy at birth, and percentage of population that is older than 65 years. In addition, the rate of kidney transplantation has increased yearly, with > 70% being performed from deceased donors. According to the numbers reported for 2013, the rates of prevalence, incidence and transplantation were (in patients per million population) 669, 149 and 19.4, respectively. Hemodialysis was the treatment of choice (90%), and 43% of the patients undergoing this treatment was located in Brazil; in contrast, peritoneal dialysis prevailed in Costa Rica, El Salvador and Guatemala. To date, the Registry remains the only source of RRT data available to healthcare authorities in many LA countries. It not only serves to promote knowledge regarding epidemiology of end-stage renal disease and the related RRT but also for training of nephrologists and renal researchers, to improve understanding and clinical application of dialysis and transplantation services. In LA, accessibility to RRT is still limited and it remains necessary to develop effective programs that will reduce risk factors, promote early diagnosis and treatment of chronic kidney disease, and strengthen transplantation programs.

Keywords: Latin America; Chronic kidney disease; Renal replacement therapy; Kidney transplantation; Prevalence; Incidence; Epidemiologic registries; Risk factors

Core tip: In Latin America (LA), patients with end-stage renal disease on renal replacement therapy (RRT) are tracked by the LA Dialysis and Transplant Registry. Data from the Registry shows increasing prevalence and incidence, which are correlated with gross national income, life expectancy at birth, and percentage of population over 65 years. The Registry represents the only source of such data in many LA countries. Its contributions to the knowledge of RRT epidemiology in LA as well as to the education and training of nephrologists are highlighted in this article, and the need for its evolution towards population-based Registries is discussed.