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BURDEN OF DISEASE PREVALENCE AND INCIDENCE OF RENAL DISEASE (ESRD) IN LATIN AMERICA GUILLERMO GARCÍA GARCÍA on behalf of [email protected]
BURDEN OF DISEASE PREVALENCE AND INCIDENCE
OF RENAL DISEASE (ESRD) IN LATIN AMERICA
GUILLERMO GARCÍA GARCÍA on behalf of
MAIN POINTS
•Demographic and socioeconomic characteristics of Latin America
•Latin America Dialysis and Renal Transplant Registry (LADTR) outcomes
•RRT prevalence & incidence in all modalities
•renal transplants
•correlation with socioeconomic variables
DEMOGRAPHIC AND SOCIOECONOMIC
CHARACTERISTICS
LATIN AMERICA •Extended from Río Bravo (México) in the North to Tierra del Fuego (Argentina) in the South
•Share the language: Spanish or Portuguese and a wide ethnic diversity
•Surface area: 22 522 000 millions km2 (13.5% of emerging surface of the planet)
•Population: 588.640.000 *
•Annual population growth rate 2000-2012: 1,1% *
•Urban population: 79.3% *
•Life expectancy at birth: 74 years*
•Older than 65 years : 7% *
•Gross national income: U$D U$ 5,477 billions *
•Gross national income per capita: U$D $ 9314 *
•Literacy rate: 93% male y 92% female *
•Human development index: 0.741 **
* http://www.worldbank.org
** www.undp.org
LATIN AMERICA SIGNIFICANT IMPROVEMENT OF SOCIOECONOMICS INDICATORS
• Life expectancy at birth: 68 to 74 years (1990-2010)
• GNI: U$D 2784 to U$D 9314 (1991-2012)
• Nicaragua & Haiti are still in the group of low income (< 1200 U$D)
• 5 countries are in the group of lower middle income (1200-3580)
• 7 countries are in the group of upper middle income (3580-7980)
• 6 countries are in the group of high income (7980-23610)
• only Puerto Rico is in the group of very high income
• % of population living below poverty line (1999-2010) from 22.4 to10.4%
• % of population living below absolute poverty line (1997-2010) from 12.0 to 5.5%
• mean health expenditure per capita U$D 713
• HDI: 0.705 a 0.741
LIFE EXPECTANCY AT BIRTH BOTH SEXES 2012
HUMAN DEVELOPMENT INDEX 2012
INEQUALITY 2013
LADRTR SWOT ANALYSIS
WEAKNESSES
voluntary reporting
wide variability in the data consistency
until 2010 Mexico data were extrapolated from state Registries
(Morelos & Guadalajara)
the number of patients living with a functioning kidney graft many
times is an estimation
STRENGHTS
continuity along the time since 1991
contributed to the development of National Registries
allowed to make comparisons among different countries and with
other registries
established the trends in the treatment of CKD in LA
YEAR 1992
• DATA FROM 18 COUNTRIES
• TOTAL NUMBER OF RRT PATIENTS: 53.950
– HD: 34.497
– PD: 17.162
– FKG: 2.291
Ecuador Guatemala
Nicaragua Rep Dominicana
Honduras Costa Rica
Panamá
Bolivia El Salvador
Paraguay
Cuba Uruguay
Colombia Perú
Puerto Rico
Chile
Venezuela
Argentina
México
Brasil
Nicaragua Paraguay
Honduras Bolivia
Costa Rica
Rep Dominicana
Guatemala Panamá
Cuba Uruguay
El Salvador Puerto Rico
Ecuador Perú
Venezuela
Chile
Colombia
Argentina
México
Brasil
YEAR 2011
• DATA FROM 20 COUNTRIES
• TOTAL NUMBER OF RRT PATIENTS 358.978
– HD: 224.764
– PD: 73.761
– FKG: 60.453
If this extrapolation was correct, the number of RRT patients of Mexico would be about 1/3 of the amount of Latin American
RRT patients
OUTCOMES
RRT PREVALENCE IN LATIN AMERICA (1991 – 2012)
119 129 131 147 173 174
199
258 278
335 352 387
424 443 478 473
522 568
605 626 613 601
0
100
200
300
400
500
600
700
800
PATI
ENTS
PM
P
YEAR
RRT PREVALENCE IN LATIN AMERICA (1991 – 2013)
(preliminary data)
119 129 131 147 173 174
199
258 278
335 352 387
424 443 478 473
522 568
605 626 613 601
627
0
100
200
300
400
500
600
700
800
PATI
ENTS
PM
P
YEAR
RRT PREVALENCE IN LATIN AMERICA BY COUNTRY
YEAR 2012
63,9
134,5
177,1
180
185,1
222,4
326,8
329,8
351,4
456,4
472,7
477,7
556,1
564,4
663,2
833,1
1038,3
1239,4
1427,6
1740,1
0 200 400 600 800 1000 1200 1400 1600 1800 2000
Nicaragua
Guatemala
Paraguay
Honduras
Rep Dominicana
Bolivia
Cuba
Costa Rica
Perú
Ecuador
Panamá
Venezuela
El Salvador
Colombia
Brasil
Argentina
Uruguay
Chile
Jalisco
Puerto Rico
PMP
EVOLUTION OF NUMBER OF RRT PATIENTS IN LATIN AMERICA
BY TREATAMENT MODALITY
(1991 – 2012)
0
50.000
100.000
150.000
200.000
250.000 1
99
2
19
93
19
94
19
95
96
/97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
20
12
Nº
OF
PATI
ENTS
YEAR
HD DP KFG
RRT PREVALENCE IN LATIN AMERICA. YEAR 2012
0 100 200 300 400 500 600 700 800 900 1000 1100 1200 1300 1400 1500 1600 1700 1800
Puerto Rico
Jalisco
Chile
Uruguay
Argentina *
Brasil
Colombia *
El Salvador
Venezuela
Panamá
Ecuador
Perú
Costa Rica
Cuba
Bolivia
Rep Dominicana
Honduras
Paraguay
Guatemala
Nicaragua
LATIN AMERICA
PATIENTS PMP
HD PD KFG
601 PMP
ẋ = 569 PMP
PREVALENCE OF RRT IN LATIN AMERICA. YEAR 2012
0% 20% 40% 60% 80% 100%
Costa Rica
El Salvador
Jalisco
Colombia *
Guatemala
Uruguay
Panamá
Brasil
Perú
Puerto Rico
Venezuela
Cuba
Argentina *
Nicaragua
Bolivia
Rep Dominicana
Chile
Paraguay
Ecuador
Honduras
PATIENTS %
HD PD KFG
449
331
143
93
88
71
61
58
41
41
39
35
24
20
17
16
12
11
10
5
-50 50 150 250 350 450
Jalisco
El Salvador
Colombia *
Puerto Rico
Panamá
Uruguay
Venezuela
Chile
Brasil
Perú
Ecuador
Argentina *
Guatemala
Costa Rica
Bolivia
Honduras
Rep Dominicana
Nicaragua
Cuba
Paraguay
PATIENTS PMP
PREVALENCE OF PD IN LATIN AMERICA.
YEAR 2012
RRT INCIDENCE IN LATIN AMERICA. YEAR 2012
0 100 200 300 400 500
Guatemala Paraguay
Jalisco Perú
Nicaragua Colombia
Bolivia Cuba
Uruguay Argentina
Brasil Chile
Ecuador Honduras
PATIENTS PMP
ẋ = 121 PMP
RENAL TRANSPLANTATION
RENAL TRANSPLANTATION RATE IN LATIN AMERICA 1987-2012
3,7
5,2 5,4 5,7
6,95,9
7,46,4
9,810,5
9,510,2
10,8
13,6 13,713,2
13,714,5
1516 16,2
16,9
18,1
19,5 19,1 19,0
0
5
10
15
20
251
98
7
19
88
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
20
12
PA
TIE
NT
S P
MP
YEAR
SOCIO-ECONOMIC INDEXES AND ESRD
PREVALENCE
NON PARAMETRICS CORRELATIONS YEAR 2010
p
GROSS NATIONAL INCOME 0.000
GROSS NATIONAL INCOME PER CAPITA 0.000
LIFE EXPECTANCY AT BIRTH 0.000
NEPHROLOGISTS PMP 0.659
R2=0,835
TRR pmp
GN
I PM
P A
THLA
S M
ETH
OD
ARGENTINA: Sergio Marinovich [email protected]
BOLIVIA: Sdenka Maury Fernández [email protected]
José Luis Valencia [email protected]
BRASIL: Jocemir R. Lugon [email protected]
CHILE: Hugo Poblete Badal [email protected]
Ana Mireya Ortiz [email protected]
Susana Elgueta Miranda [email protected]
COLOMBIA: Rafael Gómez [email protected]
COSTA RICA: Manuel Cerdas Calderón [email protected]
Fabio Hernández [email protected]
CUBA: Miguel Almaguer López [email protected]
ECUADOR: Nelly Freire [email protected]
EL SALVADOR: Ricardo Leiva Merino [email protected]
GUATEMALA: Jorge Luna Guerra [email protected]
HONDURAS: Gaspar Rodríguez [email protected]
MEXICO: Guillermo García García [email protected]
Tommaso Bochicchio [email protected]
NICARAGUA : Nubia Cano [email protected]
Norman Iron [email protected]
Danilo Rivas Miranda [email protected]
PANAMÁ: Carlos Viggiano [email protected]
PARAGUAY: Darío Cuevas [email protected]
PERÚ: Carlos Tapia [email protected]
PUERTO RICO: José L. Cangiano [email protected]
REP. DOMINICANA: Sandra Rodríguez [email protected]
URUGUAY: Maria Carlota González Bedat [email protected]
VENEZUELA: Haideé González [email protected]
SOC. DE T LA Y CARIBE: Valter Duro Garcia [email protected]
REGISTRO DE DONACIÓN Y TRASPLANTE DE LA Y CARIBE http://www.grupopuntacana.org/ver_pais.php
