Sustainable and tenable renal health model: A Latin American proposal of classification, programming, and evaluation

Calderón, Rafael Burgos; Depine, Santos Ángel

doi:10.1111/j.1523-1755.2005.09704.x

Cited by 13 publications

(5 citation statements)

References 15 publications

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“…The general and specific objectives, implementation, main strategies for generalization and the preliminary results of the pilot program have recently been published [27]. The program was planned and designed by the Uruguayan Society of Nephrology [28] according to the Latin American Society of Nephrology and Hypertension [20,21,22,23,24,25,26,27,28,29,30] and the recommendations of the consensus workshops of the International Society of Nephrology [31], and is supported by the National Resource Fund and the Public Health Ministry.…”

Section: Introductionmentioning

confidence: 99%

Improving the Management of Chronic Kidney Disease in Uruguay: A National Renal Healthcare Program

Schwedt¹,

Solá²,

Ríos³

et al. 2009

Nephron Clin Pract

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Background: Uruguay has implemented a chronic kidney disease (CKD) prevention program. Aims: The objectives of the study are to assess the results of the National Renal Healthcare Program (NRHP). Methods: This study is a cohort study of nondialysis-registered patients from October 2004 to March 2008. We made a comparison between patients under nephrology care (NC) or the care of a primary care physician (PCP; prereferral). In the outcome analysis, the primary endpoint was end-stage renal disease (ESRD) and the secondary endpoints were progression of CKD, compliance with the therapeutic goals and death. ESRD/mortality predictors were determined by Cox analysis. Results: The study comprised 2,219 patients aged 67.4 ± 13.5 years, of whom 52.5% were male, 42.1% hypertensive, 16.9% had diabetic nephropathy, and 61.3 and 21.4% were in CKD stages III and IV, respectively. At baseline, NC patients showed a better control than patients under the care of a PCP: systolic blood pressure ≧160 mm Hg (22.4 vs. 31.1%); total cholesterol <5.8 mmol/l (56.6 vs. 42.5%); and low-density lipoprotein cholesterol <2.9 mmol/l (41.2 vs. 29.1%). Control improved in patients under the care of a PCP according to years of enrollment. Outcome analysis (1,188 patients) showed a significant improvement in targets, with 56% of the patients stabilizing. CKD stage IV, diabetic nephropathy, proteinuria and hypertension increased the risk of ESRD; angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and age <65 years decreased the risk. Conclusions: Our results highlight the best management of CKD patients in both groups and the impact of the NC and renin-angiotensin-aldosterone system blockers.

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Section: Introductionmentioning

confidence: 99%

Improving the Management of Chronic Kidney Disease in Uruguay: A National Renal Healthcare Program

Schwedt¹,

Solá²,

Ríos³

et al. 2009

Nephron Clin Pract

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“…On the other hand, there are significant expenses derived from direct and indirect costs, linked to the disabilities that accompany the worsening of kidney function. In November of 2004, during the Controversies Conference on the Definition and Classification of Chronic Kidney Disease in Adults Worldwide, held in Amsterdam, Netherlands and organized by KDIGO (Kidney disease: Improving Global Outcomes), we discussed, as part of a proposal from the Latin American Society of Nephrology and Hypertension, the need to implement a kidney health model [ 60 ]. This model, globally or in its parts, was introduced to several Latin American countries, as expressed in the editorial publication of the journal Nature Clinical Practice Nephrology [ 61 ] in May 2008: “[…] a committee chaired by Santos Depine and Rafael Burgos Calderón has developed models of renal health that can be combined with the disease surveillance and prevention programs already functioning in some countries (Depine S and Calderón RB [2006] Ren Fail 28: 649–664).…”

Section: Discussionmentioning

confidence: 99%

Population Kidney Health. A New Paradigm for Chronic Kidney Disease Management

Burgos-Calderón

Depine

Aroca

2021

IJERPH

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Statistical data extracted from national databases demonstrate a continuous growth in the incidence and prevalence of chronic kidney disease (CKD) and the ineffectiveness of current policies and strategies based on individual risk factors to reduce them, as well as their mortality and costs. Some innovative programs, telemedicine and government interest in the prevention of CKD did not facilitate timely access to care, continuing the increased demand for dialysis and transplants, high morbidity and long-term disability. In contrast, new forms of kidney disease of unknown etiology affected populations in developing countries and underrepresented minorities, who face socioeconomic and cultural disadvantages. With this background, our objective was to analyze in the existing literature the effects of social determinants in CKD, concluding that it is necessary to strengthen current kidney health strategies, designing in a transdisciplinary way, a model that considers demographic characteristics integrated into individual risk factors and risk factors population, incorporating the population health perspective in public health policies to improve results in kidney health care, since CKD continues to be an important and growing contributor to chronic diseases.

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“…Por lo tanto, la evaluación de la implementación de estrategias multidisciplinarias está directamente relacionado con los recursos disponibles por el sistema de salud. (18) La atención de nefrología debe incluir además la educación del paciente, con respecto a diferentes terapias de reemplazo renal, asesoramiento dietético, colocación temprana del acceso vascular y asistencia psicológica y de asistencia social (19) . En este sentido y teniendo en cuenta que nuestro país no cuenta con un programa nacional de salud renal, se debe indicar que el manejo multidisciplinario si está contemplado en el Plan Nacional de salud renal de EsSALUD y en la Guía de Manejo de Enfermedad renal crónica de esta institución (20) , donde se indica que se requiere un manejo de varios profesionales para lograr ciertos indicadores en pacientes con enfermedad renal crónica.…”

Section: Modelo Multidisciplinario En La Atención De La Enfermedad Re...unclassified

Enfoque multidisciplinario en la atención de pacientes con enfermedad renal crónica. Una revisión narrativa

Bravo-Zúñiga

2023

Rev Med Hered

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La enfermedad renal crónica (ERC) es un importante problema de salud pública. En el Perú al momento no existe un programa nacional de salud renal. Existe evidencia que el modelo multidisciplinario de atención en ERC mejora la calidad de atención y ha mostrado que enlentece la progresión de ERC y disminuye la mortalidad por todas las causas. Aunque aún hay puntos controversiales, como, por ejemplo, desde que nivel de tasa de filtración glomerular se debería iniciar el manejo multidisciplinario, es una práctica que ha mejorado la atención y el seguimiento de los pacientes renales. Sin embargo, se requiere para su implementación recursos financieros y profesionales y una capacidad organizativa del sistema de salud, que quizás en nuestro país se convierte en un reto.

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Sustainable and tenable renal health model: A Latin American proposal of classification, programming, and evaluation

Abstract: The implementation of the Renal Health Program in health ministries of Latin American and Caribbean countries would allow for a substantial improvement in renal health prevention and management, as a result of better distribution of financial and human resources.

Cited by 13 publications

References 15 publications

Improving the Management of Chronic Kidney Disease in Uruguay: A National Renal Healthcare Program

Improving the Management of Chronic Kidney Disease in Uruguay: A National Renal Healthcare Program

Population Kidney Health. A New Paradigm for Chronic Kidney Disease Management

Enfoque multidisciplinario en la atención de pacientes con enfermedad renal crónica. Una revisión narrativa

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