Epidemiología de la insuficiencia renal crónica en México
Epidemiology of chronic kidney failure in Mexico
Antonio Méndez-Durán a, J.Francisco Méndez-Bueno b, Teresa Tapia-Yáñez c, Angélica Muñoz Montes d, Leticia Aguilar-Sánchez e
a Hospital General Regional N.o 25, Instituto Mexicano del Seguro Social, Distrito Federal, México.
b Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Distrito Federal, México
c Hospital General de Zona N.o 24, Instituto Mexicano del Seguro Social, Distrito Federal, México
d Hospital General Regional N.o 27, Instituto Mexicano del Seguro Social, Distrito Federal, México
e Áreas Médicas, Dirección de Prestaciones Médicas, Instituto Mexicano del Seguro Social, Distrito Federal, México
Palabras ClaveEpidemiología. Enfermedad renal crónica. Diálisis peritoneal. Hemodiálisis. Prevalencia. Incidencia
KeywordsEpidemiology. Chronic kidney disease. Peritoneal dialysis. Hemodialysis. Prevalence. Incidence
Resumen Introduction and objective: In Mexico, end-stage renal failure is a catastrophic disease and there is no electronic database allowing the characteristics of patients in dialysis programs to be accurately determined. The general objective of this study was to identify the epidemiological characteristics of patients receiving renal replacement therapy. Patients and methods: Retrospective data of prevalent patients in the dialysis programs of secondary care medical units of the public health system in Mexico were studied. Gender, age, causes of chronic renal failure, morbidity, rate of peritonitis (patient/months), causative agents, and peak incidence during the year were analyzed. Mortality was grouped into cardiovascular, metabolic and infectious causes. Survival was estimated on the basis of the number of months the patient remained in the program. This study posed no ethical dilemmas for the patients or investigators. There were no conflicts of interest to declare. Results: A total of 31,712 patients from 127 general hospitals were included: 20,702 under peritoneal dialysis and 11,010 under hemodialysis. The mean age was 60 years (range: 10-84). The causes of chronic renal failure were diabetes mellitus (48.5%), hypertension (19%), chronic glomerulopathies (12.7%) and others (19.8%). The main cause of morbidity in peritoneal dialysis was peritonitis, while the main causes in hemodialysis were anemic syndrome and infection of the vascular access, of which 77% were Mahurkar type. Causes of death were cardiovascular and infectious. There was substantial demand for nephrologists. Conclusions: The findings of this study were similar to those of other published series. The implementation a program for the early detection of chronic renal disease at the first consultation, a larger number of nephrologists, predialysis clinics, and vascular access, as well as an electronic registry of patients with chronic renal failure, are areas for improvement.