Renal replacement therapy in Latin America

The Latin American Society of Nephrology and Hypertension (SLANH) Dialysis and Renal Transplantation Registry was created in October 1991 as a multinational, mainly voluntary registry. Annual data reports on the incidence, prevalence and outcome of renal replacement therapy (RRT) in the region have been issued. The RRT prevalence increased from 123 per million population (pmp) in 1992 to 180 pmp in 1997, and the acceptance rate was 57 pmp in 1997. Among incident patients, 32.8% were older than 65 years and 24% had diabetic nephropathy. Mortality rate in dialysis patients was 152 deaths per 1000 patient-years at risk. The low acceptance rate is mainly a consequence of economic and health care system difficulties in Latin American countries. A large number of patients in this region do not reach RRT due to restricted availability and difficulties in referral. There are important demographic, socioeconomic, acceptance availabilities, and questionnaire response rate heterogeneity among Latin American countries. Because of this heterogeneity, it is very difficult to compare data obtained from different countries of this region of the world. To overcome this difficulty is the critical challenge for the future activity of the SLANH Registry.