Unmet Needs of CKD in Latin America: A Review from Expert Virtual Working Group

Abstract

Chronic kidney disease (CKD) represents a major challenge for Latin American (LatAm) because of its epidemic proportions. Therefore, the current status and knowledge of CKD in Latin America is not clearly understood. Moreover, there is a paucity of epidemiologic studies that makes the comparison across the countries even more difficult. To address these gaps, a virtual kidney expert opinion meeting of 14 key opinion leaders from Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, Guatemala, Mexico, and Panama was held in January 2022 to review and discuss the status of CKD in various LatAm regions. The meeting discussed the following: (i) epidemiology, diagnosis, and treatment of CKD, (ii) detection and prevention programs, (iii) clinical guidelines, (iv) state of public policies about diagnosis and management of chronic kidney disease, and (v) role of innovative therapies in the management of CKD. The expert panel emphasized that efforts should be made to implement timely detection programs and early evaluation of kidney function parameters to prevent the development or progression of CKD. Furthermore, the panel discussed the importance of raising awareness among health care professionals; disseminating knowledge to the authorities, the medical community, and the general population about the kidney and cardiovascular benefits of novel therapies; and the need for timely updating of clinical practice guidelines, regulatory policies, and protocols across the region.

Keywords: chronic kidney disease; clinical practice guidelines; kidney failure; kidney replacement therapy; national kidney failure registries; national policies.

Figure 1

Prevalence of CKD in Latin America. Adapted from Wainstein et al.: ISN-GKHA: Latin America.

Figure 2

Patient journey and role of HCPs. CKD, chronic kidney disease; HCP, health care professional; KF, kidney failure; OTC, over-the-counter; PCP, primary care physician.

Figure 3

Proceedings of kidney expert opinion meet 2022–a stepwise approach. CKD, chronic kidney disease; KOL, key opinion leaders; LatAm, Latin America.

Figure 4

Some described opportunities for improving CKD detection and prevention programs. CKD, chronic kidney disease; MOH, Ministry of Health; PCP, primary care physician; SENASA, National Health Insurance; SISALRIL, Superintendent of Health and Labor Risks; SINAVE, National Epidemiologic Surveillance System; SNS, National Health Service. ^aA successful pilot program that links the PCPs alongside the nephrologists through a predefined questionnaire that should be filled by the PCPs and send to the nephrology department where the nephrologists take <3 days to revert.

Figure 5

Overall analysis (percentage) of CKD situation in the participating countries. CKD, chronic kidney disease; LatAm, Latin America. ^aArgentina, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, Guatemala, Mexico, Panama.