Renal replacement therapy for stage 5 chronic kidney disease in the Cayman Islands

There has been no documentation on the epidemiology of end stage renal disease (ESRD) in the Cayman Islands. We retrospectively surveyed all facilities providing renal replacement therapy in the Cayman Islands in order to define the epidemiology of kidney failure in this setting. The prevalence of ESRD in this population was 0.975 persons per 1,000 population. There were 48 patients with kidney failure who received replacement therapy either by chronic hemodialysis (36) or kidney transplants (12). The method of access for maintenance hemodialysis was tunneled internal jugular catheter access (3), native arteriovenous fistulae (13) and prosthetic arteriovenous grafts (20). Currently, there is a low prevalence of maintenance hemodialysis by native fistulae (36.1%). A directed effort to increase the use of native fistulae is now necessary to meet the goals set by the National Kidney Foundation and Center for Medicaid Services. Otherwise, renal replacement therapy for patients with ESRD in the Cayman Islands exceeds the standards recommended by the National Kidney Foundation. In order to ensure continued delivery of modern quality care, further audits of the local practice will be required at regular intervals.