Resumen
La enfermedad renal es un problema global de salud pública que afecta a más de 750 millones de personas alrededor de todo el mundo1. La carga de la enfermedad renal varía sustancialmente a lo largo del planeta, al igual que su detección y tratamiento. A pesar de que la magnitud y el impacto de la enfermedad renal está mejor definida en los países desarrollados, evidencia reciente sugiere que los países en desarrollo tienen una carga de la enfermedad similar o incluso mayor que los primeros2.En muchos escenarios, las tasas de enfermedad renal y la provisión de su cuidado están definidas por factores socioeconómicos, culturales y políticos, ocasionando disparidades significativas en la carga de la enfermedad, aún en países desarrollados3. Estas disparidades existen a lo largo de todo el espectro de la enfermedad renal – desde los esfuerzos preventivos para limitar el desarrollo de la lesión renal aguda (LRA) o de la enfermedad renal crónica (ERC), al tamizaje para enfermedad renal entre las personas con alto riesgo de desarrollarla, al acceso a cuidado y tratamiento subespecializado de la falla renal con terapia de reemplazo renal (TRR). El Día Mundial del Riñón 2019 ofrece una oportunidad para hacer conciencia de la enfermedad renal y resaltar las disparidades en su carga y el estado actual de la capacidad global para su prevención y manejo. En esta editorial, resaltamos estas disparidades y hacemos énfasis en el rol de las políticas públicas y las estructuras organizacionales en su atención. También destacamos las oportunidades de mejorar nuestro entendimiento de las disparidades en la enfermedad renal, la major formas de que éstas puedan ser reducidas, y como canalizar esfuerzos enfocados a alcanzar una salud renal con equidad a lo largo del planeta.
Citas
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2. Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease-a systematic review and metaanalysis. PLoS One. 2016;11:e0158765.
3. Crews DC, Liu Y, Boulware LE. Disparities in the burden, outcomes, and care of chronic kidney disease. Curr Opin Nephrol Hypertens. 2014;23:298-305.
4. Bello AK, Levin A, Tonelli M, et al. Global Kidney Health Atlas: a report by the International Society of Nephrology on the current state of organization and structures for kidney care across the globe. https://www.theisn.org/images/ISN_advocacyGKHAtlas_Linked_Compressed1.pdf. Published 2017. Accessed August 22, 2018.
5. Stanifer JW, Jing B, Tolan S, et al. The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta- analysis. Lancet Glob Health. 014;2:e174-e181.
6. Davids MR, Eastwood JB, Selwood NH, et al. A renal registry for Africa: first steps. Clin Kidney J. 2016;9:162-167.
7. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause- specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459-1544.
8. Liyanage T, Ninomiya T, Jha V, et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975-1982.
9. Mehta RL, Cerda J, Burdmann EA, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet. 2015;385:2616-2643.
10. Samuel SM, Palacios-Derflingher L, Tonelli M, et al. Association between First Nations ethnicity and progression to kidney failure by presence and severity of albuminuria. CMAJ. 2014;186:E86-E94.
11. Nicholas SB, Kalantar-Zadeh K, Norris KC. Racial disparities in kidney disease outcomes. Semin Nephrol. 2013;33:409-415.
12. Van den Beukel TO, de Goeij MC, Dekker FW, et al. Differences in progression to ESRD between black and white patients receiving predialysis care in a universal health care system. Clin J Am Soc Nephrol. 2013;8:1540-1547.
13. Crews DC, Gutierrez OM, Fedewa SA, et al. Low income, community poverty and risk of end stage renal disease. BMC Nephrol. 2014;15:192.
14. Garrity BH, Kramer H, Vellanki K, et al. Time trends in the association of ESRD incidence with area-level poverty in the US population. Hemodial Int. 2016;20:78-83.
15. Parsa A, Kao WH, Xie D, et al. APOL1 risk variants, race, and progression of chronic kidney disease. N Engl J Med. 2013; 369:2183-2196.
16. Peralta CA, Bibbins-Domingo K, Vittinghoff E, et al. APOL1 genotype and race differences in incident albuminuria and renal function decline. J Am Soc Nephrol. 2016;27:887-893.
17. Correa-Rotter R. Mesoamerican nephropathy or chronic kidney disease of unknown origin. In: García- García G, Agodoa LY, Norris KC, eds. Chronic Kidney Disease in Disadvantaged Populations. Cambridge, MA: Academic Press; 2017:221-228.
18. Levin A, Stevens PE, Bilous RW, et al. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1-150.
19. Chan JC, Gregg EW, Sargent J, Horton R. Reducing global diabetes burden by implementing solutions and identifying gaps: a Lancet Commission. Lancet. 2016;387:1494-1495.
20. Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-223.
21. Plantinga LC, Miller ER 3rd, Stevens LA, et al. Blood pressure control among persons without and with chronic kidney disease: US trends and risk factors 1999-2006. Hypertension. 2009;54:47-56.
22. Banerjee T, Liu Y, Crews DC. Dietary patterns and CKD progression. Blood Purif. 016;41:117-122.
23. Johnson AE, Boulware LE, Anderson CA, et al. Perceived barriers and facilitators of using dietary modification for CKD prevention among African Americans of low socioeconomic status: a qualitative study. BMC Nephrol. 2014;15:194.
24. Crews DC, Kuczmarski MF, Miller ER 3rd, et al. Dietary habits, poverty, and chronic kidney disease in an urban population. J Ren Nutr. 2015;25:103-110.
25. Suarez JJ, Isakova T, Anderson CA, et al. Food access, chronic kidney disease, and hypertension in the U.S. Am J Prev Med. 2015;49:912-920.
26. Crews DC, Kuczmarski MF, Grubbs V, et al. Effect of food insecurity on chronic kidney disease in lower-income Americans. Am J Nephrol. 2014;39:27-35.
27. Banerjee T, Crews DC, Wesson DE, et al. Food insecurity, CKD, and subsequent ESRD in US adults. Am J Kidney Dis. 2017;70:38-47.
28. Piccoli GB, Alrukhaimi M, Liu ZH, et al. Women and kidney disease: reflections on World Kidney Day 2018. Kidney Int. 2018;93:278-283.
29. Food and Agriculture Organization of the United Nations. The FAO hunger map 2015. http://www.fao.org/3/a-i4674e.pdf. Published 2015. Accessed August 22, 2018.
30. Shariff ZM, Khor GL. Obesity and household food insecurity: evidence from a sample of rural households in Malaysia. Eur J Clin Nutr. 2005;59:1049-1058.
31. Popkin BM. Contemporary nutritional transition: determinants of diet and its impact on body composition. Proc Nutr Soc. 2011;70:82-91.
32. Sawhney S, Marks A, Fluck N, et al. Intermediate and long-term outcomes of survivors of acute kidney injury episodes: a large population-based cohort study. Am J Kidney Dis. 2017;69:18-28.
33. Heung M, Steffick DE, Zivin K, et al. Acute kidney injury recovery pattern and subsequent risk of CKD: an analysis of Veterans Health Administration data. Am J Kidney Dis. 2016;67:742-752.
34. Grams ME, Matsushita K, Sang Y, et al. Explaining the racial difference in AKI incidence. J Am Soc Nephrol. 2014;25:1834-1841.
35. Luyckx VA, Tuttle KR, Garcia-Garcia G, et al. Reducing major risk factors for chronic kidney disease. Kidney Int Suppl. 2017;7:71-87.
36. Lewington AJ, Cerda J, Mehta RL. Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidney Int. 2013;84:457-467.
37. Cervantes L, Tuot D, Raghavan R, et al. Association of emergency-only vs standard hemodialysis with mortality and health care use among undocumented immigrants with end-stage renal disease. JAMA Intern Med. 2018;178:188-195.
38. Rizvi SA, Naqvi SA, Zafar MN, Akhtar SF. A kidney transplantation model in a low-resource country: an experience from Pakistan. Kidney Int Suppl. 2013;3:236-240.
39. Roberti J, Cummings A, Myall M, et al. Work of being an adult patient with chronic kidney disease: a systematic review of qualitative studies. BMJ Open. 2018;8:e023507.
40. Kierans C, Padilla-Altamira C, Garcia-Garcia G, et al. When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients. PLoS One. 2013;8:e54380.
41. Murray CJ, Frenk J. A framework for assessing the performance of health systems. Bull World Health Organ. 2000;78:717-731.
42. Htay H, Alrukhaimi M, Ashuntantang GE, et al. Global access of patients with kidney disease to health technologies and medications: findings from the Global Kidney Health Atlas project. Kidney Int Suppl. 2018;8:64-73.
43. Osman MA, Alrukhaimi M, Ashuntantang GE, et al. Global nephrology workforce: gaps and opportunities toward a sustainable kidney care system. Kidney Int Suppl. 2018;8:52-63.
44. World Health Organization. Global Health Observatory indicator views. http://apps.who.int/gho/data/node. imr#ndx-P. Accessed August 22, 2018.
45. Harris DC, Dupuis S, Couser WG, Feehally J. Training nephrologists from developing countries: does it have a positive impact? Kidney Int Suppl. 2012;2:275-278.
46. Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int. 2011;80:1258-1270.
47. Chionh CY, Soni SS, Finkelstein FO, et al. Use of peritoneal dialysis in AKI: a systematic review. Clin J Am Soc Nephrol. 2013;8:1649-1660.
48. Muralidharan A, White S. The need for kidney transplantation in low- and middle- ncome countries in 2012: an epidemiological perspective. Transplantation. 015;99:476-478.
2. Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease-a systematic review and metaanalysis. PLoS One. 2016;11:e0158765.
3. Crews DC, Liu Y, Boulware LE. Disparities in the burden, outcomes, and care of chronic kidney disease. Curr Opin Nephrol Hypertens. 2014;23:298-305.
4. Bello AK, Levin A, Tonelli M, et al. Global Kidney Health Atlas: a report by the International Society of Nephrology on the current state of organization and structures for kidney care across the globe. https://www.theisn.org/images/ISN_advocacyGKHAtlas_Linked_Compressed1.pdf. Published 2017. Accessed August 22, 2018.
5. Stanifer JW, Jing B, Tolan S, et al. The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta- analysis. Lancet Glob Health. 014;2:e174-e181.
6. Davids MR, Eastwood JB, Selwood NH, et al. A renal registry for Africa: first steps. Clin Kidney J. 2016;9:162-167.
7. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause- specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459-1544.
8. Liyanage T, Ninomiya T, Jha V, et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975-1982.
9. Mehta RL, Cerda J, Burdmann EA, et al. International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet. 2015;385:2616-2643.
10. Samuel SM, Palacios-Derflingher L, Tonelli M, et al. Association between First Nations ethnicity and progression to kidney failure by presence and severity of albuminuria. CMAJ. 2014;186:E86-E94.
11. Nicholas SB, Kalantar-Zadeh K, Norris KC. Racial disparities in kidney disease outcomes. Semin Nephrol. 2013;33:409-415.
12. Van den Beukel TO, de Goeij MC, Dekker FW, et al. Differences in progression to ESRD between black and white patients receiving predialysis care in a universal health care system. Clin J Am Soc Nephrol. 2013;8:1540-1547.
13. Crews DC, Gutierrez OM, Fedewa SA, et al. Low income, community poverty and risk of end stage renal disease. BMC Nephrol. 2014;15:192.
14. Garrity BH, Kramer H, Vellanki K, et al. Time trends in the association of ESRD incidence with area-level poverty in the US population. Hemodial Int. 2016;20:78-83.
15. Parsa A, Kao WH, Xie D, et al. APOL1 risk variants, race, and progression of chronic kidney disease. N Engl J Med. 2013; 369:2183-2196.
16. Peralta CA, Bibbins-Domingo K, Vittinghoff E, et al. APOL1 genotype and race differences in incident albuminuria and renal function decline. J Am Soc Nephrol. 2016;27:887-893.
17. Correa-Rotter R. Mesoamerican nephropathy or chronic kidney disease of unknown origin. In: García- García G, Agodoa LY, Norris KC, eds. Chronic Kidney Disease in Disadvantaged Populations. Cambridge, MA: Academic Press; 2017:221-228.
18. Levin A, Stevens PE, Bilous RW, et al. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3:1-150.
19. Chan JC, Gregg EW, Sargent J, Horton R. Reducing global diabetes burden by implementing solutions and identifying gaps: a Lancet Commission. Lancet. 2016;387:1494-1495.
20. Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-223.
21. Plantinga LC, Miller ER 3rd, Stevens LA, et al. Blood pressure control among persons without and with chronic kidney disease: US trends and risk factors 1999-2006. Hypertension. 2009;54:47-56.
22. Banerjee T, Liu Y, Crews DC. Dietary patterns and CKD progression. Blood Purif. 016;41:117-122.
23. Johnson AE, Boulware LE, Anderson CA, et al. Perceived barriers and facilitators of using dietary modification for CKD prevention among African Americans of low socioeconomic status: a qualitative study. BMC Nephrol. 2014;15:194.
24. Crews DC, Kuczmarski MF, Miller ER 3rd, et al. Dietary habits, poverty, and chronic kidney disease in an urban population. J Ren Nutr. 2015;25:103-110.
25. Suarez JJ, Isakova T, Anderson CA, et al. Food access, chronic kidney disease, and hypertension in the U.S. Am J Prev Med. 2015;49:912-920.
26. Crews DC, Kuczmarski MF, Grubbs V, et al. Effect of food insecurity on chronic kidney disease in lower-income Americans. Am J Nephrol. 2014;39:27-35.
27. Banerjee T, Crews DC, Wesson DE, et al. Food insecurity, CKD, and subsequent ESRD in US adults. Am J Kidney Dis. 2017;70:38-47.
28. Piccoli GB, Alrukhaimi M, Liu ZH, et al. Women and kidney disease: reflections on World Kidney Day 2018. Kidney Int. 2018;93:278-283.
29. Food and Agriculture Organization of the United Nations. The FAO hunger map 2015. http://www.fao.org/3/a-i4674e.pdf. Published 2015. Accessed August 22, 2018.
30. Shariff ZM, Khor GL. Obesity and household food insecurity: evidence from a sample of rural households in Malaysia. Eur J Clin Nutr. 2005;59:1049-1058.
31. Popkin BM. Contemporary nutritional transition: determinants of diet and its impact on body composition. Proc Nutr Soc. 2011;70:82-91.
32. Sawhney S, Marks A, Fluck N, et al. Intermediate and long-term outcomes of survivors of acute kidney injury episodes: a large population-based cohort study. Am J Kidney Dis. 2017;69:18-28.
33. Heung M, Steffick DE, Zivin K, et al. Acute kidney injury recovery pattern and subsequent risk of CKD: an analysis of Veterans Health Administration data. Am J Kidney Dis. 2016;67:742-752.
34. Grams ME, Matsushita K, Sang Y, et al. Explaining the racial difference in AKI incidence. J Am Soc Nephrol. 2014;25:1834-1841.
35. Luyckx VA, Tuttle KR, Garcia-Garcia G, et al. Reducing major risk factors for chronic kidney disease. Kidney Int Suppl. 2017;7:71-87.
36. Lewington AJ, Cerda J, Mehta RL. Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidney Int. 2013;84:457-467.
37. Cervantes L, Tuot D, Raghavan R, et al. Association of emergency-only vs standard hemodialysis with mortality and health care use among undocumented immigrants with end-stage renal disease. JAMA Intern Med. 2018;178:188-195.
38. Rizvi SA, Naqvi SA, Zafar MN, Akhtar SF. A kidney transplantation model in a low-resource country: an experience from Pakistan. Kidney Int Suppl. 2013;3:236-240.
39. Roberti J, Cummings A, Myall M, et al. Work of being an adult patient with chronic kidney disease: a systematic review of qualitative studies. BMJ Open. 2018;8:e023507.
40. Kierans C, Padilla-Altamira C, Garcia-Garcia G, et al. When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients. PLoS One. 2013;8:e54380.
41. Murray CJ, Frenk J. A framework for assessing the performance of health systems. Bull World Health Organ. 2000;78:717-731.
42. Htay H, Alrukhaimi M, Ashuntantang GE, et al. Global access of patients with kidney disease to health technologies and medications: findings from the Global Kidney Health Atlas project. Kidney Int Suppl. 2018;8:64-73.
43. Osman MA, Alrukhaimi M, Ashuntantang GE, et al. Global nephrology workforce: gaps and opportunities toward a sustainable kidney care system. Kidney Int Suppl. 2018;8:52-63.
44. World Health Organization. Global Health Observatory indicator views. http://apps.who.int/gho/data/node. imr#ndx-P. Accessed August 22, 2018.
45. Harris DC, Dupuis S, Couser WG, Feehally J. Training nephrologists from developing countries: does it have a positive impact? Kidney Int Suppl. 2012;2:275-278.
46. Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int. 2011;80:1258-1270.
47. Chionh CY, Soni SS, Finkelstein FO, et al. Use of peritoneal dialysis in AKI: a systematic review. Clin J Am Soc Nephrol. 2013;8:1649-1660.
48. Muralidharan A, White S. The need for kidney transplantation in low- and middle- ncome countries in 2012: an epidemiological perspective. Transplantation. 015;99:476-478.
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