Four decades of kidney transplantation in Cuba.

This article describes the background, beginnings, development, evolution and outcomes of kidney transplantation in Cuba. Nephrology as a medical specialty in Cuba began in 1962 and was formalized in 1966. Conditions were created to implement renal replacement therapy (including transplants), bring nephrology care to the entire country and train human resources who would assume this responsibility, making Cuba one of the first countries with a comprehensive program for renal patient care. After three unsuccessful cadaveric-donor kidney transplantations in 1968-69, the ensuing history of kidney transplantation can be summarized in the following three stages. 1970-1975: In January 1970, cadaveric-donor kidney transplantation began at the Nephrology Institute. That year, 17 kidney transplantations were performed; four of these patients lived with functional kidneys for 15-25 years; 10-year graft survival was 23.5% (Kaplan-Meier survival curve); HLA typing began in 1974. By December 1975, 170 grafts had been done in three hospitals. 1976-1985: Seven transplantation centers performed 893 grafts during this period. HLA-DR typing was introduced in 1976 and the National Histocompatibility Laboratory Network was founded in 1978. The first related living-donor kidney transplantation was done in 1979. 1986-2011: The National Kidney Transplantation Coordinating Center and the National Kidney Transplantation Program were created in 1986; the first combined kidney-pancreas transplantation was performed the same year. In 1990, cyclosporine and the Cuban monoclonal antibody IOR-T3 were introduced for immunosuppression to prevent rejection, as were other Cuban products (hepatitis B vaccine and recombinant human erythropoietin) for transplant patients. By December 2011, the cumulative number of transplants was 4636 (384 from related living donors). With over 40 years of experience, kidney transplantation is now well established in Cuba; it is free and universally accessible, on the basis of need and appropriateness.

Incidencia y prevalencia de hipertensión arterial registradas en el Día Mundial de la Hipertensión 2011: experiencia de un grupo de trabajo / Incidence and prevalence of high blood pressure registered at the High Blood Pressure World Day-2011: experience of a working party

Introducción: se realizó un estudio de corte transversal y en 2 centros de trabajo, la Dirección Nacional del INDER y la Facultad de Cultura Física Dr. Manuel Fajardo de La Habana, en el Día Mundial de la Hipertensión Arterial. Objetivos: determinar la frecuencia de hipertensos (conocidos y nuevos) y de prehipertensos, el porcentaje de pacientes tratados y controlados y la presencia de sobrepeso entre los normotensos e hipertensos. Además, demostrar la importancia de que cada persona conozca cuál es su presión arterial y el riesgo de padecerla. Métodos: se investigaron 730 personas de ambos sexos con predominio de jóvenes atletas que voluntariamente respondieron la encuesta y se les midió la presión arterial. Se llenó un modelo que contenía las variables seleccionadas: edad, sexo, talla, peso, si conocían si eran hipertensos, si recibían tratamiento farmacológico y las cifras de presión arterial encontradas. Se confeccionó una base de datos y se empleó el sistema estadístico SPSS de Window 2007. Los resultados se expresaron en frecuencias absolutas y porcentajes. Resultados: el 58,5 por ciento correspondió al sexo masculino. La distribución etaria en los 3 percentiles empleados mostró franco predominio de jóvenes (50 por ciento). De los 730 sujetos encuestados, 114 (15,6 por ciento) conocían que eran hipertensos (15,4 por ciento de los hombres y 16,2 por ciento de las mujeres), 106 (14,5 por ciento) fueron clasificados como prehipertensos y 35 (4,8 por ciento), como nuevos hipertensos. De los 114 hipertensos conocidos, 91 (61,7por ciento) tenían tratamiento y 87 estaban controlados (58,4 por ciento del total y 95,6 por ciento de los tratados) y no controlados 62 (41,6 por ciento del total y 4,4 por ciento de los tratados). De los prehipertensos, 82 (77 por ciento) estaban en edades de 19 a 49 años, 40 porciento de ellos con sobrepeso, mientras que 24 (23 por ciento) tenían 50 o más años, pero con 70 por ciento de sobrepeso...(AU)

Introduction: a cross-sectional study was conducted in two institutions: The National Management of Recreation and Sports National Institute and in the Dr. Manuel Fajardo Physical Culture Faculty of La Habana at the High Blood Pressure World Day. Objectives: to determine the frequency of hypertensive patients (known and new) and the pre-hypertensive ones, the percentage of patients treated and controlled as well as the presence of excess weight among those with a normal blood pressure and the hypertensive ones, as well as to demonstrate also the significance that each person knows which is its blood pressure and its risk. Methods: authors studied 730 patients of both sexes with predominance of the young athletes who voluntarily answered the survey, measuring the blood pressure. A form including the select variables was fill out: age, sex, height, weight, if they know on its hypertensive status, if they were receiving drug treatment and the blood pressure figures found. A database was created using the SPSS statistic system of Window 2007. Results were expressed in absolute frequencies and percentages. Results: the 58,5 percent corresponded to male sex. Age distribution in the three percentiles used showed an open predominance of young people (50 percent). From the 730 polled subjects, 114 (15,6 percent) knew its hypertensive status (15,4 percent of men and 16,2 % of women), 106 (14,5 percent) were classified as pre-hypertensives and 35 (4,8 percent) as new hypertensives. From the 114 known hypertensive, 91 (61,7percent) were under treatment and 87 were controlled (58,4 percent of total and the 95,6 percent of those treated) and 62 no-controlled (41,6 percent of total and 4,4 percent of those treated). From the hypertensive ones, 82 (77 percent) were aged 19-49, the 40 percent of them had excess weight, whereas 24 (23 percent) were aged 50 or more, but with a 70 percent of excess weight...(AU)

Incidencia y prevalencia de hipertensión arterial registradas en el Día Mundial de la Hipertensión 2011: experiencia de un grupo de trabajo / Incidence and prevalence of high blood pressure registered at the High Blood Pressure World Day-2011: experience of a working party

Introducción: se realizó un estudio de corte transversal y en 2 centros de trabajo, la Dirección Nacional del INDER y la Facultad de Cultura Física Dr. Manuel Fajardo de La Habana, en el Día Mundial de la Hipertensión Arterial. Objetivos: determinar la frecuencia de hipertensos (conocidos y nuevos) y de prehipertensos, el porcentaje de pacientes tratados y controlados y la presencia de sobrepeso entre los normotensos e hipertensos. Además, demostrar la importancia de que cada persona conozca cuál es su presión arterial y el riesgo de padecerla. Métodos: se investigaron 730 personas de ambos sexos con predominio de jóvenes atletas que voluntariamente respondieron la encuesta y se les midió la presión arterial. Se llenó un modelo que contenía las variables seleccionadas: edad, sexo, talla, peso, si conocían si eran hipertensos, si recibían tratamiento farmacológico y las cifras de presión arterial encontradas. Se confeccionó una base de datos y se empleó el sistema estadístico SPSS de Window 2007. Los resultados se expresaron en frecuencias absolutas y porcentajes. Resultados: el 58,5 por ciento correspondió al sexo masculino. La distribución etaria en los 3 percentiles empleados mostró franco predominio de jóvenes (50 por ciento). De los 730 sujetos encuestados, 114 (15,6 por ciento) conocían que eran hipertensos (15,4 por ciento de los hombres y 16,2 por ciento de las mujeres), 106 (14,5 por ciento) fueron clasificados como prehipertensos y 35 (4,8 por ciento), como nuevos hipertensos. De los 114 hipertensos conocidos, 91 (61,7por ciento) tenían tratamiento y 87 estaban controlados (58,4 por ciento del total y 95,6 por ciento de los tratados) y no controlados 62 (41,6 por ciento del total y 4,4 por ciento de los tratados). De los prehipertensos, 82 (77 por ciento) estaban en edades de 19 a 49 años, 40 porciento de ellos con sobrepeso, mientras que 24 (23 por ciento) tenían 50 o más años, pero con 70 por ciento de sobrepeso...

Introduction: a cross-sectional study was conducted in two institutions: The National Management of Recreation and Sports National Institute and in the Dr. Manuel Fajardo Physical Culture Faculty of La Habana at the High Blood Pressure World Day. Objectives: to determine the frequency of hypertensive patients (known and new) and the pre-hypertensive ones, the percentage of patients treated and controlled as well as the presence of excess weight among those with a normal blood pressure and the hypertensive ones, as well as to demonstrate also the significance that each person knows which is its blood pressure and its risk. Methods: authors studied 730 patients of both sexes with predominance of the young athletes who voluntarily answered the survey, measuring the blood pressure. A form including the select variables was fill out: age, sex, height, weight, if they know on its hypertensive status, if they were receiving drug treatment and the blood pressure figures found. A database was created using the SPSS statistic system of Window 2007. Results were expressed in absolute frequencies and percentages. Results: the 58,5 percent corresponded to male sex. Age distribution in the three percentiles used showed an open predominance of young people (50 percent). From the 730 polled subjects, 114 (15,6 percent) knew its hypertensive status (15,4 percent of men and 16,2 % of women), 106 (14,5 percent) were classified as pre-hypertensives and 35 (4,8 percent) as new hypertensives. From the 114 known hypertensive, 91 (61,7percent) were under treatment and 87 were controlled (58,4 percent of total and the 95,6 percent of those treated) and 62 no-controlled (41,6 percent of total and 4,4 percent of those treated). From the hypertensive ones, 82 (77 percent) were aged 19-49, the 40 percent of them had excess weight, whereas 24 (23 percent) were aged 50 or more, but with a 70 percent of excess weight...

Chronic kidney disease in Cuba: epidemiological studies, integral medical care, and strategies for prevention.

The experience of the Republic of Cuba regarding epidemiological studies, integral medical care, and strategies for the prevention of chronic kidney disease is summarized in this report. Cuba has a National Program for Chronic Renal Disease, Dialysis, and Renal Transplantation. There is a national nephrology net, integrated by the Institute of Nephrology as the coordinator center, that has 47 nephrology services with a hemodialysis unit (24 of them with peritoneal dialysis unit), 9 transplantation centers, 33 organ procurement hospitals, and 5 histocompatibility laboratories. In 2004, the incidence rate in dialysis patients was 111 pmp, and the prevalence rate was 149 pmp, demonstrating an increasing mean of 17.0% and 10.0% per year, respectively. Renal transplantation rate was 16.6 pmp. The detection, registration, and follow-up of patients with chronic kidney disease (serum creatinine > or =1.5 mg/dL or glomerular filtration rate <60 mL/min) by family doctors was 9,761 patients, 0.87 patients per 1,000 inhabitants. In the 1980s, three population-based screening studies were performed to define the burden of chronic renal failure in different regions of Cuba. The prevalence rate was 1.1, 3.3, and 3.5 per 1,000 inhabitants, respectively. At present, another three population-based screening studies are ongoing in order to detect the chronic kidney disease in earliest stages. The continuing medical education activities have been very useful in raising the awareness of medical doctors and the basic health staff about the threats posed by and the strategies to prevent, diagnose, and treat chronic kidney disease.