Latin American Dialysis and Transplant Registry: Experience and contributions to end-stage renal disease epidemiology

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.