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PD IN THE DEVELOPING WORLD |
Unidad de Investigación Médica en Epidemiología Clínica, UMAE, Hospital de Especialidades, CMNO, IMSS, Guadalajara, Mexico
Correspondence to: A.M. Cueto-Manzano, Unidad de Investigación
Médica en Epidemiología Clínica, Hospital de
Especialidades, 4 piso, CMNO, Belisario Dominguez 1000, Col. Independencia,
Guadalajara, Jalisco, CP44349,
Mexico.
a_cueto_manzano{at}hotmail.com
Mexico is struggling to gain a place among developed countries; however,
there are many socioeconomic and health problems still waiting for resolution.
While Mexico has the twelfth largest economy in the world, a large portion of
its population is impoverished. Treatment for end-stage renal disease (377
patients per million population) is determined by the individual's access to
resources such as private medical care (approximately 3%) and public sources
(Social Security System: approximately 40%; Health Secretariat: approximately
57%). With only 6% of the gross national product spent on healthcare and most
treatment providers being public health institutions that are often under
economic restrictions, it is not surprising that many Mexican patients do not
receive renal replacement therapy. Mexico is still the country with the
largest utilization of peritoneal dialysis (PD) in the world, with 18% on
automated PD, 56% on continuous ambulatory PD (CAPD), and 26% on hemodialysis.
Results of PD (patient morbi-mortality, peritonitis rate, and technique
survival) in Mexico are comparable to other countries. However, malnutrition
and diabetes mellitus are highly prevalent in Mexican patients on CAPD
programs, and these conditions are among the most important risk factors for a
poor outcome in our setting.
KEY WORDS: KEY WORDS:; Mexico; diabetes mellitus; malnutrition.
Received 7 September 2005; accepted 6 April 2006.
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