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Acceso mundial al tratamiento para la enfermedad renal terminal: una revisión sistemática

Thaminda Liyanage¹, Toshiharu Ninomiya², Vivekanand Jha³

¹George Institute for Global Health, University of Sydney, Sydney, NSW, Australia; Royal North Shore Hospital, Sydney, NSW, Australia.

Lancet (London, England)

|March 18, 2015

Resumen

Millones de personas en todo el mundo necesitan terapia de reemplazo renal (TRR), pero muchos no tienen acceso, lo que lleva a muertes prematuras. Las proyecciones muestran una duplicación del uso de RRT para 2030, destacando la necesidad urgente de tratamientos accesibles y estrategias de prevención.

Área de la Ciencia:

Nefrología Nefrología.
Salud Pública La salud pública.
Epidemiología La epidemiología.

Sus antecedentes:

La enfermedad renal en estadio terminal (ESKD, por sus siglas en inglés) es un desafío significativo para la salud mundial, que causa una morbilidad y mortalidad generalizadas.
La demanda de terapia de reemplazo renal (TRR) está aumentando rápidamente en todo el mundo.
La estimación de la carga actual y futura de ESKD y RRT es crucial para la planificación de la atención médica.

Objetivo del estudio:

Para cuantificar la carga global de la ESKD.
Para estimar la prevalencia actual y la demanda futura de RRT.
Identificar las brechas de tratamiento, especialmente en las regiones de bajos ingresos.

Principales métodos:

Búsqueda sistemática de la literatura de estudios observacionales y registros renales.
Ponerse en contacto con expertos nacionales para obtener datos de prevalencia de RRT.
Utilizando la regresión de Poisson para estimar la prevalencia de RRT en regiones con escasez de datos.
Proyección de las necesidades de RRT para el año 2030.

Principales resultados:

En 2010, 2.618 millones de personas recibieron RRT en todo el mundo.
Se estima que entre 4,9 y 9,7 millones de personas necesitaban RRT en 2010, lo que indica un déficit potencial de al menos 2,284 millones.
Las mayores brechas de tratamiento se observaron en Asia y África.
Se prevé que el uso global de RRT supere los 5.4 millones para 2030, con un crecimiento sustancial previsto en Asia.

Conclusiones:

Un número significativo de personas requiere RRT, mientras que una parte sustancial carece de acceso.
Existe una necesidad crítica para el desarrollo de tratamientos RRT rentables.
Es esencial implementar estrategias efectivas de prevención basadas en la población para la enfermedad renal.

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