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INTERNATIONAL COOPERATION REPORT Specialists Look at Renal Disease in the Region Specialists gather this month in Cuba for the 9th Central American and Caribbean Congress on Nephrology and Hypertension, to coincide with the 3rd International Meeting on Nephrology Nursing and Cuba’s own 7th National Congress on Nephrology. Dr. Jorge Alfonzo, President of the Cuban Society of Nephrology, told MEDICC Review that prevention of chronic kidney disease is the main focus of the event, which has attracted participants from the region, as well as Europe, North and South America, and Asia. Some 400 Cuban and 250 international physicians, nurses and other health professionals whose work is related to renal disease are expected. In keeping with the main theme, the Congress opens with the lecture “A Global Perspective on Kidney Disease: Implications for Central America and the Caribbean” by Dr. John Dirks, Chair of the International Society of Nephrology’s Commission for the Global Advancement of Nephrology (COMGAN), from the University of Toronto. Central America and the Caribbean are comprised of 34 countries, with 76 million inhabitants. Over 40% live in poverty. Communicable and non-communicable diseases both have significant impact on morbidity and mortality, and chronic disease prevalence is projected to increase with current aging trends of the population. Obesity is at epidemic levels among the near-poor. Prevalence in total population of diabetes mellitus is 6%-8%; and hypertension 8%-30% - although both conditions are certainly under-diagnosed in almost all countries.
The most recent data from the Latin American Registry (2001) indicates that, except for Puerto Rico, the incidence of chronic patients in dialysis in Central America and the Caribbean is 60 pmp or fewer, and prevalence in dialysis is fewer than 100 pmp. Several countries have no program for renal replacement therapy. As with other developing countries, says Dr. Alfonzo, “prevention is our best hope in the region for stemming the tide of chronic kidney disease, and other conditions associated with it.” The Congress Agenda Prevention at all levels of healthcare is an underlying theme guiding the work of the entire Congress as it focuses on such areas as:
The main sessions (May 15-18) are preceded by several pre-Congress courses:
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The region’s racial-ethnic composition - associated with difficult socio-economic conditions - can be compared to U.S. minorities, which show significantly greater rates of CKD than those registered in Central America and the Caribbean. Thus, the region may well be among the world’s most seriously threatened by CKD – a reality obscured by the lack of health care coverage and consequent underreporting, as indicated by an excessively low prevalence of patients in dialysis.