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      Terapia renal de reemplazo dialítica en cuba: tendencia durante los últimos 10 años Translated title: Dialitic renal replacement therapy in cuba: trend over the past 10 years

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          Abstract

          Introducción: la especialidad de Nefrología existe en Cuba, desde 1966. Ante los avances y el perfeccionamiento desarrollado en la Salud Pública es importante evaluar los cambios en los métodos dialíticos. Objetivo: reportar la tendencia de la terapia renal de reemplazo dialítica (TRR-D) en el país en el período 2001-2011. Método: el reporte incluye los datos de los indicadores de estructura, proceso y resultado de los pacientes, quienes reciben métodos dialíticos crónicos, recolectados por el Centro Coordinador del Programa Atención Nacional Enfermedad Renal, Diálisis y Trasplante (PANER). Resultados: el acceso a las TRR-D es universal y gratuito. El total de Servicios se incrementó de 24 en 2001 a 49 en 2011. La prevalencia en TRR-D crece; en 2001, fue de 150 por Millón de Población, a 243 pMP en el 2011. La hipertensión (34%) y la diabetes (27%) son las principales causas de Enfermedad Renal Crónica terminal. Las posibles explicaciones del incremento de pacientes en métodos dialíticos y la disminución de la mortalidad bruta están dadas por el incremento en las capacidades dialíticas, la mejoría tecnológica, el empleo de eritropoyetina a todos los que la requieran con la mejoría de la anemia, entre otras. Conclusión: la TRR-D, en Cuba, se ha incrementado en el período 2001-2011; ha aumentado el número de especialistas en Nefrología, su competencia, expresado en la mejoría de los resultados clínicos, consecuencia del acercamiento multidisciplinario a los pacientes, la mejor atención a sus comorbilidades y, en primer término, por la prioridad brindada por el Estado a este Programa a todos los niveles del Sistema.

          Translated abstract

          Introduction: the nephrology in Cuba has been since 1966. Chronic Kidney Disease is now recognized as a global public health problem. As health improvement development in Cuba, it is important to evaluate the changes in dialysis status. We report the dialysys Program trend over de past 10 years. Methods: this report includes data of indicators of structure, process and results defined from patients who were receiving chronic dialysis treament over he past 2001-2011. Data was collected by the Center of PANER. Results: access to dialysis care is a right of every Cuban citizen and all treatment modalities are availables and it is universal. The total number of Services increase of 24 in 2001 to 49 in 2011 The prevalence of D-RRT continue to grow: in 2001 was 150 pMP, ant the 2011 of 243 pMP. Hypertension (34%) and diabetes (27%) are the leading cause of renal disease. In our case the possible explanations for the increase of patients and decrease of the crude mortality are of the increase in the capabilities of hemodialysis, improvements in technology, the use of erythropoietin and iron to all who need, between others. Conclusion: the dialysis RRT in Cuba has increased over the past 10 years, at the expense of the haemodialysis, as the clinical results have improved by the increase in the number of nephrologists their expertise and competence, comprehensive, multidisciplinary approach to patient care, the best treatment of comorbidities and the priority given to the Program at all levels of the health system.

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          Most cited references25

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          Unraveling the racial disparities associated with kidney disease.

          In the United States, chronic kidney disease (CKD), and in particular end-stage renal disease (ESRD), represent a growing problem. Many other countries also have an increasing number of ESRD cases. Racial/ethnic disparities have been documented globally in the prevalence, incidence, and treatment of CKD, most extensively in the United States, but also in the United Kingdom, Australia, and New Zealand, among others. In many circumstances, these disparities are of a negative nature, that is, certain racial/ethnic groups fare worse than their white counterparts with respect to the treatment or outcome of CKD. However, in a few circumstances, they are of a positive nature, such as the survival advantage seen in minorities with ESRD compared with whites. The reasons for racial disparities in the prevalence, incidence, and treatment of CKD are not fully understood, although they are explained partly by coexisting medical conditions and modifiable risk factors, such as socioeconomic, lifestyle, and cultural. It is likely, however, that the complete picture incorporates a complex interaction between these sociocultural, genetic, and environmental factors. In a global society that prides itself on a high level of sensitivity and equality, there is an ethical and moral imperative to address the continuing racial/ethnic disparities in CKD and many of the factors underlying this epidemic. We review data highlighting the racial/ethnic disparities that exist in the incidence and treatment of CKD, with particular emphasis on ESRD. A better understanding of both the negative and positive racial/ethnic disparities may yield important insights, which can inform future research strategies and improve health outcomes for all patients afflicted with CKD.
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            Chronic Kidney Disease: A Public Health Problem That Needs a Public Health Action Plan

            For a health problem or condition to be considered a public health issue, four criteria must be met: 1) the health condition must place a large burden on society, a burden that is getting larger despite existing control efforts; 2) the burden must be distributed unfairly (i.e., certain segments of the population are unequally affected); 3) there must be evidence that upstream preventive strategies could substantially reduce the burden of the condition; and 4) such preventive strategies are not yet in place. Chronic kidney disease meets these criteria for a public health issue. Therefore, as a complement to clinical approaches to controlling it, a broad and coordinated public health approach will be necessary to meet the burgeoning health, economic, and societal challenges of chronic kidney disease.
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              USRDS 2005 Annual Data Report; Atlas of End-Stage Renal Disease in the United States

              (2005)
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                Author and article information

                Journal
                rhcm
                Revista Habanera de Ciencias Médicas
                Rev haban cienc méd
                Universidad de Ciencias Médicas de la Habana (La Habana )
                1729-519X
                September 2012
                : 11
                : 3
                : 424-433
                Article
                S1729-519X2012000300014
                72f18a62-82be-4dd5-9f52-dc17bdf3f8c2

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=1729-519X&lng=en
                Categories
                HEALTH CARE SCIENCES & SERVICES

                Health & Social care
                peritoneal dialysis and stage renal diseases,dialytic renal replacement therapy,incidencia,prevalencia,enfermedad renal crónica,diálisis,terapia renal de remplazo dialítica,incidence,prevalence,haemodialysis

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