Carga, acceso y disparidades en enfermedad renal
Resumen
La enfermedad renal es un problema global de salud pública que afecta a más de 750 millones de personas alrededor de todo el mundo. 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 primeros.En muchos escenarios, las tasas de enfermedad renal y la provision de su cuidado están definidas por factores socioeconómicos, culturales y políticos, ocasionando disparidades significativas en la carga de la enfermedad, aún en países desarrollados. 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
GBD 2015 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1603-1658.
Hill NR, Fatoba ST, Oke JL, Hirst JA, O'Callaghan CA, Lasserson DS, et al. Global Prevalence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis. PLoS One. 2016;11(7):e0158765.
Crews DC, Liu Y, Boulware LE. Disparities in the burden, outcomes, and care of chronic kidney disease. Curr Opin Nephrol Hypertens. 2014;23(3):298-305.
Bello AK, Johnson DW, Feehally J, Harris D, Jindal K, Lunney M, et al. Global Kidney Health Atlas (GKHA): design and methods. Kidney Int Suppl. 2017;7(2):145-53.
Stanifer JW, Jing B, Tolan S, Helmke N, Mukerjee R, Naicker S, et al. The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(3):e174-81.
Davids MR, Eastwood JB, Selwood NH, Arogundade FA, Ashuntantang G, Benghanem Gharbi M, et al. A renal registry for Africa: first steps. Clin Kidney J. 2016;9(1):162-7.
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(10053):1459-544.
Liyanage T, Ninomiya T, Jha V, Neal B, Patrice HM, Okpechi I, et al. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385(9981):1975-82.
Mehta RL, Cerdá J, Burdmann EA, Tonelli M, García-García G, Jha V, 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(9987):2616-43.
Samuel SM, Palacios-Derflingher L, Tonelli M, Manns B, Crowshoe L, Ahmed SB, et al. Association between First Nations ethnicity and progression to kidney failure by presence and severity of albuminuria. CMAJ. 2014;186(2):E86-94.
Nicholas SB, Kalantar-Zadeh K, Norris KC. Racial disparities in kidney disease outcomes. Semin Nephrol. 2013;33(5):409-15.
van den Beukel TO, de Goeij MC, Dekker FW, Siegert CE, Halbesma N; PREPARE Study Group. 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(9):1540-7.
Crews DC, Gutiérrez OM, Fedewa SA, Luthi JC, Shoham D, Judd SE, et al. Low income, community poverty and risk of end stage renal disease. BMC Nephrol. 2014;15:192.
Garrity BH, Kramer H, Vellanki K, Leehey D, Brown J, Shoham DA. Time trends in the association of ESRD incidence with area-level poverty in the US population. Hemodial Int. 2016;20(1):78-83.
Parsa A, Kao WH, Xie D, Astor BC, Li M, Hsu CY, et al. APOL1 risk variants, race, and progression of chronic kidney disease. N Engl J Med. 2013;369(23):2183-96.
Peralta CA, Bibbins-Domingo K, Vittinghoff E, Lin F, Fornage M, Kopp JB, et al. APOL1 Genotype and Race Differences in Incident Albuminuria and Renal Function Decline. J Am Soc Nephrol. 2016;27(3):887-93.
Correa-Rotter R. Mesoamerican nephropathy or chronic kidney disease of unknown origin. En: García- García G, Agodoa LY, Norris KC, eds. Chronic Kidney Disease in Disadvantaged Populations. Cambridge, MA: Academic Press; 2017:221-8.
Levin A, Stevens PE, Bilous RW, 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):1-150.
Chan JC, Gregg EW, Sargent J, Horton R. Reducing global diabetes burden by implementing solutions and identifying gaps: a Lancet Commission. Lancet. 2016;387(10027):1494-5.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217-23.
Plantinga LC, Miller ER 3rd, Stevens LA, Saran R, Messer K, Flowers N, et al. Blood pressure control among persons without and with chronic kidney disease: US trends and risk factors 1999-2006. Hypertension. 2009;54(1):47-56.
Banerjee T, Liu Y, Crews DC. Dietary Patterns and CKD Progression. Blood Purif. 2016;41(1-3):117-22.
Johnson AE, Boulware LE, Anderson CA, Chit-ua-aree T, Kahan K, Boyér LL, 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.
Crews DC, Kuczmarski MF, Miller ER 3rd, Zonderman AB, Evans MK, Powe NR. Dietary habits, poverty, and chronic kidney disease in an urban population. J Ren Nutr. 2015;25(2):103-10.
Suarez JJ, Isakova T, Anderson CA, Boulware LE, Wolf M, Scialla JJ. Food Access, Chronic Kidney Disease, and Hypertension in the U.S. Am J Prev Med. 2015;49(6):912-20.
Crews DC, Kuczmarski MF, Grubbs V, Hedgeman E, Shahinian VB, Evans MK, et al. Effect of food insecurity on chronic kidney disease in lower-income Americans. Am J Nephrol. 2014;39(1):27-35.
Banerjee T, Crews DC, Wesson DE, Dharmarajan S, Saran R, Ríos Burrows N, et al. Food Insecurity, CKD, and Subsequent ESRD in US Adults. Am J Kidney Dis. 2017;70(1):38-47.
Piccoli GB, Alrukhaimi M, Liu ZH, Zakharova E, Levin A. Women and kidney disease: reflections on World Kidney Day 2018. Kidney Int. 2018; 93(2):278-83.
Food and Agriculture Organization of the United Nations. FAO Hunger Map 2015 [Internet]. Disponible en: http://www.fao.org/3/a-i4674e.pdf (citado: 22/08/2018).
Shariff ZM, Khor GL. Obesity and household food insecurity: evidence from a sample of rural households in Malaysia. Eur J Clin Nutr. 2005;59(9):1049-58.
Popkin BM. Contemporary nutritional transition: determinants of diet and its impact on body composition. Proc Nutr Soc. 2011;70(1):82-91.
Sawhney S, Marks A, Fluck N, Levin A, Prescott G, Black C. Intermediate and Long-term Outcomes of Survivors of Acute Kidney Injury Episodes: A Large Population-Based Cohort Study. Am J Kidney Dis. 2017;69(1):18-28.
Heung M, Steffick DE, Zivin K, Gillespie BW, Banerjee T, Hsu CY, 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(5):742-52.
Grams ME, Matsushita K, Sang Y, Estrella MM, Foster MC, Tin A, et al. Explaining the racial difference in AKI incidence. J Am Soc Nephrol. 2014;25(8):1834-41.
Luyckx VA, Tuttle KR, Garcia-Garcia G, Benghanem Gharbi M, Heerspink HJL, Johnson DW, et al. Reducing major risk factors for chronic kidney disease. Kidney Int Suppl. 2017;7(2):71-87.
Lewington AJ, Cerdá J, Mehta RL. Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidney Int. 2013;84(3):457-67.
Cervantes L, Tuot D, Raghavan R, Linas S, Zoucha J, Sweeney L, 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(2):188-195.
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(2):236-40.
Roberti J, Cummings A, Myall M, Harvey J, Lippiett K, Hunt K, et al. Work of being an adult patient with chronic kidney disease: a systematic review of qualitative studies. BMJ Open. 2018;8(9):e023507.
Kierans C, Padilla-Altamira C, Garcia-Garcia G, Ibarra-Hernandez M, Mercado FJ. When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients. PLoS One. 2013;8(1):e54380.
Murray CJ, Frenk J. A framework for assessing the performance of health systems. Bull World Health Organ. 2000;78(6):717-31.
Htay H, Alrukhaimi M, Ashuntantang GE, Bello AK, Bellorin-Font E, Benghanem Gharbi M, 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(2):64-73.
Osman MA, Alrukhaimi M, Ashuntantang GE, Bellorin-Font E, Benghanem Gharbi M, Braam B, et al. Global nephrology workforce: gaps and opportunities toward a sustainable kidney care system. Kidney Int Suppl. 2018;8(2):52-63.
World Health Organization. Global Health Observatory indicator views [Internet]. Disponible en: http://apps.who.int/gho/data/node.imr (citado: 22/08/2018).
Harris DC, Dupuis S, Couser WG, Feehally J. Training nephrologists from developing countries: does it have a positive impact? Kidney Int Suppl. 2012;2(3):275-8.
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(12):1258-70.
Chionh CY, Soni SS, Finkelstein FO, Ronco C, Cruz DN. Use of peritoneal dialysis in AKI: a systematic review. Clin J Am Soc Nephrol. 2013;8(10):1649-60.
Muralidharan A, White S. The need for kidney transplantation in low- and middle-income countries in 2012: an epidemiological perspective. Transplantation. 2015;99(3):476-81.
