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Representatives from 19 Latin American countries gathered to report and deliberate on both the present and future implications of the growing epidemic of chronic kidney disease—as well as cardiovascular disease, diabetes, and hypertension—and to define the role that national health systems need to adopt in order to cope with them. Country-by-country reports provided an excellent overview of the current state of health care in general and chronic diseases in particular. The meeting concluded with a consensus statement on the most urgent needs for the next decade. [ABSTRACT FROM AUTHOR]

Unassigned: Kidney replacement therapy (KRT) initiated in Latin America towards the second half of the 20th century, starting with dialytic therapies and, shortly thereafter, with kidney transplant. By the end of 2021, close to half a million Latin Americans were under KRT, with an overall unadjusted prevalence of 872 per million persons (pmp), yet with significant heterogeneity between nations. By treatment modality, 68% of prevalent patients were treated with hemodialysis (HD), 9% with peritoneal dialysis (PD), and 23% were living with a functioning kidney graft (LFG). In the last decade, HD is the KRT that has had the largest growth, and it also has incorporated newer and better technologies. Nevertheless, Latin America shows heterogeneity between countries, and as a region we are far from achieving full accessibility to all in need of KRT. While there has been growth and improvement in existing renal dialysis registries, and several countries that did not previously have these registries have implemented them, there are still some nations with limited or absent registry implementation. The number of nephrologists in the region is heterogeneous, with only four countries having an appropriate group of specialists. The remaining nations have an important need to expand nephrology training programs. SLANH is a major regional player in addressing these topics and supporting the expansion of appropriate nephrology programs to improve inequalities and patient care. (Rev Invest Clin. 2023;75(6):300-8)., (Copyright: © 2023 Permanyer.)

Background: Anemia almost invariably occurs in patients with chronic kidney disease. Limited data are available regarding anemia management in Latin American (LA) hemodialysis (HD) patients., Objective: To evaluate the results of the first anemia survey of the Anemia Committee of the SLANH., Methods: This is a multinational, voluntary survey that collected anemia management data from adult HD patients from independent, non-chain owned HD units, between 09/2009 and 03/2010. T-test, ANOVA, chi-square test and multivariate logistic regression were used for statistical analysis., Results: The survey received responses from 134 HD units of 16 countries providing data from 9,025 patients. Mean values of Hb, ferritin, and transferrin saturation (TSAT) were 10.5 ± 1.8 g/dL, 570 ± 539 µg/l, and 29.8 ± 15%, respectively. Only 32.7% of patients were within the Hb target of 10.5-12.0 g/dL (46.3% were below and 21.1% above). Erythropoietin-stimulating agents (ESAs) were administered to 84.3% patients and 68.3% received intravenous iron (IV). Iron deficiency (TSAT≤20%) was present in 27.5% patients and among those receiving erythropoietin, 47% did not achieve Hb target. The independent variables associated with the lowest Hb level (<10.5 g/dL) were: female gender, TSAT<25% and age<50 years., Conclusions: According to these results, nearly half of LA chronic HD patients did not achieve the recommended Hb target despite wide use of ESAs and IV iron.

In recent decades, Latin America (LA) has experienced profound demographic and epidemiologic changes conditioning an enormous increase in prevalence and incidence of chronic non-communicable diseases. End-stage renal disease has steadily increased in prevalence and incidence (478.2 and 168.7 pmp, respectively) and is emerging as a devastating medical, social, and economic problem for patients, families, and national health systems. The development of successful renal replacement treatment modalities has emphasized the wide breach in healthcare between developed and emerging nations. LA is composed of many nations that have a common social and cultural background yet exhibit significant variations in socioeconomic status, ethnicities, and human development. In addition, the region is experiencing a type 2 diabetes mellitus epidemic and a constant growth of related end-stage renal disease which at present is not sustainable and will be unaffordable in most countries, unless changes in public health policy and a new focus on the problem is generated. Renal transplantation, though increasing, cannot revert the growing prevalence. The development of public health policies and prevention programs is mandatory in LA and requires a better knowledge of prevalence and distribution of risk factors in the different nations of the region., ((c) 2008 S. Karger AG, Basel.)