Kidney Replacement Therapy in Latin America, 2020 Data

ABSTRACT

Introduction: 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. The main goals of the LADRTR is to promote the development of national registries, consolidate a data system for KRT in Latin America (LA), return the data provided by nephrologist to the different stakeholders that participate in the decision making process, while contributing to the universal knowledge of prevention, incidence and evolution of the disease in the region. This summarizes the registry data for 2020. Method(s) 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 2020 were collected from the World Bank Data Bank. Prevalence and incidence were compared with previous years and were also correlated with GDP and LEB. Result(s) On 31 December 2020 the prevalence of KRT in LA was 848 per million population (pmp), which shows a drop in the rate compared to the previous year (Figure 1). The prevalence ranged from 2129 pmp in Puerto Rico to 111 pmp in Nicaragua. Eight countries had a rate >700 pmp (Argentina, Brazil, Chile, Colombia, Ecuador, Panama, Puerto Rico and Uruguay). The states of Mexico, Jalisco and Aguas Calientes, also had a rate >700 pmp (Figure 2). Regarding treatment modality, 67,0% of the prevalent patients were treated with HD (n= 290 099) and 9.3% with PD (n= 40 450) while 23,6% of the patients had an LFG (n= 102772). The total unadjusted incidence rate of patients that started KRT was 158 pmp. The majority of the patients started KRT with HD modality, while only 6,08% used PD, varying the rate of incidence from 477 pmp in Jalisco and Aguas Calientes to 2 pmp in Bolivia. The kidney transplant rate in the region was 15 pmp, showing a drop from the previous year, and 89% of KT were from a deceased donor (Figure 3). The total prevalence of KRT correlated positively with GDP per capita (r 2 = 0.6, P < 0.01) and LEB (r 2 = 0.27, P < 0.05). The overall unadjusted mortality rate was 18%, cardiac disease was the leading cause of death (31%), followed by infectious diseases (21%) and other causes (16%). [Formula presented] [Formula presented] [Formula presented] Conclusion(s) For the first time in the last decade the overall prevalence and kidney transplant rate decreased, being this associated with COVID-19 pandemic. Although the incidence and prevalence of KRT in the LA region have increased over the years, there is still a need to improve accessibility to KRT, develop programs that facilitate better control of risk factors, early diagnosis and the treatment of chronic kidney disease, as well as the implementation of an effective kidney transplant program, to reduce the gap that exists between the countries of LA. No conflict of interestCopyright © 2023