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PERITONEAL DIALYSIS IN LATIN AMERICA |
1 Unidad de Investigación Médica en Enfermedades Renales, UMAE Hospital de Especialidades, CMNO, IMSS, Guadalajara, Mexico; 2 Center for Health and Biological Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
Correspondence to: A.M. Cueto-Manzano, Unidad de Investigación
Médica en Epidemiología Clínica, UMAE Hospital de
Especialidades, CMNO, IMSS, Guadalajara,
Mexico.
a_cueto_manzano{at}hotmail.com
Peritoneal dialysis (PD) patients present an extremely high mortality rate,
but the mechanisms mediating the increased risk of mortality observed in this
group of patients are still largely unknown, which limits the perspective of
effective therapeutic strategies. The leading hypothesis that tries to explain
this high mortality risk is that PD patients are exposed to a number of
traditional risk factors for cardiovascular disease (CVD) already at the onset
of their chronic kidney disease (CKD), since many of these risk factors are
common to both CVD and CKD. Of particular importance, chronic inflammation
recently emerged as an important novel risk factor related to multiple
complications of CKD. There are many stimuli of the inflammatory response in
CKD patients, such as fluid overload, decreased cytokine clearance, presence
of uremia-modified proteins, presence of chronic infections, metabolic
disturbances (including hyperglycemia), obesity. Many of these factors are
related to PD. Latin America has made some progress in economic issues;
however, a large portion of the population is still living in poverty, in poor
sanitary conditions, and with many health-related issues, such as an
increasing elderly population, low birth weights, and increasingly high energy
intake in the adult population, which, in combination with changes in
lifestyle, has provoked an increase in the prevalence of obesity, diabetes,
and CVD. Therefore, in Latin America, there seems to be a peculiar situation
combining high prevalence of low education level, poor sanitary conditions,
and poverty with increases in obesity, diabetes, and sedentary lifestyle.
Since inflammation and mortality risk are intimately related to both sides of
those health issues, in this review we aim to analyze the peculiarities of
inflammation and mortality risk in the Latin-American PD population.
KEY WORDS: KEY WORDS:; Latin America; inflammation; cardiovascular risk.
Received 25 January 2007; accepted 23 February 2007.
This article has been cited by other articles:
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  T. P. Moraes, R. Pecoits-Filho, S. C. Ribeiro, M. Rigo, M. M. Silva, P. S. Teixeira, D. D. Pasqual, R. Fuerbringer, and M. C. Riella PERITONEAL DIALYSIS IN BRAZIL: TWENTY-FIVE YEARS OF EXPERIENCE IN A SINGLE CENTER Perit. Dial. Int., September 1, 2009; 29(5): 492 - 498. [Abstract] [Full Text] [PDF]
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