Accessibility to Kidney Replacement Therapy in Latin America.

Latin America is made up of 21 countries with a population of around 660 million, of whom 550,000 receive kidney replacement therapy (KRT). The enormous burden of disease that KRT imposes can be attributed to multiple determinants of the disease, linked to the characteristics of the population: co-morbidity, social factors, limited access to the health care system, poverty, extreme working conditions, and low levels of education. In many countries, the health care system is fragmented, making it difficult to ensure the continuity of the health care process and to adress inequities in access to KRT. Differences among countries in the prevalence of KRT translate into thousands of lives lost each year. Differences in access to KRT are linked to structural and investment differences in health care systems, so financing and organization characteristicsmight have a major bearing on equitable access to KRT. One of the main objectives of the nephrology community should be to develop activities to reduce gaps in the burden of KRT. There is no doubt that alliances with health care policy makers, ministries of health, regional patient organizations, regional nursing organizations, health regulatory agencies, and international nephrology societies will achieve results by working together, in synergy.