PAHO/WHO calls for better access to treatment for kidney disease

By PAHO/WHO

PRESS RELEASE – The Pan American Health Organization/World Health Organization (PAHO/WHO) and the Latin American Society of Nephrology and Hypertension (SLANH) are calling for more efforts to prevent chronic kidney disease and expanded access to treatment for patients.

The two organizations have joined forces to promote strategies to bridge the gap between patients with advanced kidney disease and access to treatments that can prolong and save their lives.

World Kidney Disease DayChronic kidney disease, which can be prevented but not be cured, affects up to 10% of the world’s population. The disease tends to be gradual and silent, showing symptoms only at advanced stages when treatments—dialysis and kidney transplantation—are highly invasive and expensive.

Many countries lack the resources to cover the costs of these treatments for those who need them, and there are insufficient available medical specialists to meet the demand.

“The data we have are still insufficient, but they suggest there are major inequities in access to treatment for chronic kidney disease in the Americas,” said Pedro Ordúñez, PAHO/WHO’s regional advisor on prevention and control of chronic diseases.

“Lower-income countries and populations are at a clear disadvantage. If action is not taken to prevent this disease before it reaches its advanced stages, more people will suffer from it, and countries will face higher future health costs.”

According to SLANH data, as of 2011, an average of 613 patients per million inhabitants in Latin America had access to some treatment options for lost kidney function: hemodialysis (performed by a machine), peritoneal dialysis (using a catheter and fluids in the abdomen), or kidney transplantation.

That average, however, masks highly inequitable distribution of these services; in certain countries, fewer than 200 per million inhabitants have access to treatment options.

PAHO/WHO and SLANH are promoting actions to increase access to kidney replacement therapy to 700 patients per million inhabitants in every Latin American country by 2019.

“In such a big continent, with major access barriers––especially for populations far from health centers––we need to extend home-based peritoneal dialysis, a safe, effective treatment that could reach many patients who are not receiving treatment today,” said SLANH President Walter Douthat.

Home-based peritoneal dialysis is currently offered to an average 12% of patients in Latin America, with availability of as low as 6% in some countries and as high as 30% in others. SLANH is proposing that every country in the Americas make the treatment available to at least 20% of their population by 2019.

“There are many things we can do to make access to treatment more equitable,” said Ordúñez. He cited improved prevention and early detection, strengthening of surveillance to better understand the situation in each country, training for more nephrologists and health workers to address the shortage in specialized personnel, and expanded coverage for treatment, especially for patients in advanced stages of the disease.

The most effective ways to prevent kidney disease are through healthy lifestyles and improved treatment and control of diabetes and hypertension. Other major risk factors include poor working conditions and irresponsible use of agricultural chemicals, as has been observed in Central American agricultural communities.

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