دورية أكاديمية
Chronic kidney disease in Ecuador: An epidemiological and health system analysis of an emerging public health crisis.
العنوان: | Chronic kidney disease in Ecuador: An epidemiological and health system analysis of an emerging public health crisis. |
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المؤلفون: | Torres I; Fundacion Octaedro, Quito, Ecuador., Sippy R; SUNY Upstate Medical University, Syracuse, New York, United States of America.; University of Florida, Gainesville, Florida, United States of America., Bardosh KL; Center for One Health Research, School of Public Health, University of Washington, Seattle, Washington, United States of America., Bhargava R; SUNY Upstate Medical University, Syracuse, New York, United States of America., Lotto-Batista M; SUNY Upstate Medical University, Syracuse, New York, United States of America.; Department of Epidemiology, Helmholtz Centre for Infection Research, Brunswick, Germany., Bideaux AE; SUNY Upstate Medical University, Syracuse, New York, United States of America., Garcia-Trabanino R; Centro de Hemodiálisis, San Salvador, El Salvador.; Emergency Social Fund for Health, Tierra Blanca, El Salvador., Goldsmith A; Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America., Narsipur SS; SUNY Upstate Medical University, Syracuse, New York, United States of America., Stewart-Ibarra AM; SUNY Upstate Medical University, Syracuse, New York, United States of America.; Inter-American Institute for Global Change Research (IAI), Montevideo, Uruguay. |
المصدر: | PloS one [PLoS One] 2022 Mar 16; Vol. 17 (3), pp. e0265395. Date of Electronic Publication: 2022 Mar 16 (Print Publication: 2022). |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: San Francisco, CA : Public Library of Science |
مواضيع طبية MeSH: | Kidney Failure, Chronic*/therapy , Kidney Transplantation* , Renal Insufficiency, Chronic*/diagnosis , Renal Insufficiency, Chronic*/epidemiology , Renal Insufficiency, Chronic*/therapy, Ecuador/epidemiology ; Female ; Humans ; Male ; Public Health ; Renal Dialysis |
مستخلص: | The absence of a chronic kidney disease (CKD) registry in Ecuador makes it difficult to assess the burden of disease, but there is an anticipated increase in the incidence of CKD along with increasing diabetes, hypertension and population age. From 2012, augmented funding for renal replacement therapy expanded dialysis clinics and patient coverage. We conducted 73 in-depth sociological interviews with healthcare providers in eight provinces and collected quantitative epidemiological data on patients with CKD diagnoses from six national-level databases between 2015 and 2018. Datasets show a total of 17,484 dialysis patients in 2018, or 567 patients per million population (pmp), with an annual cost exceeding 11% of Ecuador's public health budget. Each year, there were 139-162 pmp new dialysis patients, while doctors reported waiting lists. The number of patients on peritoneal dialysis was static; those on hemodialysis increased over time. Only 13 of 24 provinces were found to have dialysis services, and nephrologists were clustered in major cities, which limits access, delays medical attention, and adds a travel burden on patients. Prevention and screening programs are scarce, while hospitalization is an important reality for CKD patients. CKD is an emerging public health crisis that has increased dramatically over the last decade in Ecuador and is expected to continue, making coverage for all patients impossible and the current structure, unsustainable. A patient registry would help health policymakers and administrators estimate the demand and progression of patients with consideration for comorbidities, disease stage, requirements and costs, mortality and follow-up. This should be used to help identify where to focus prevention and improved treatment efforts. Organized monitoring of CKD patients would benefit from improvements in patient referral. Community-based education and prevention programs, the strengthening of primary healthcare capacity (including basic routine tests) and improved nephrology services are also urgently needed. Competing Interests: The authors have declared that no competing interests exist. |
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تواريخ الأحداث: | Date Created: 20220316 Date Completed: 20220503 Latest Revision: 20220503 |
رمز التحديث: | 20221213 |
مُعرف محوري في PubMed: | PMC8926192 |
DOI: | 10.1371/journal.pone.0265395 |
PMID: | 35294504 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1932-6203 |
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DOI: | 10.1371/journal.pone.0265395 |