Panorama epidemiológico de la insuficiencia renal crónica en el segundo nivel de atención del Instituto Mexicano del Seguro Social

Abstract

IntroductionAn institutional register of patients with developing dialysis is currently available. General objectiveThe aim was to identify epidemiological aspects of chronic renal failure (CRF) in the Mexican Institute of Social Security. Material and methodsThis was a retrospective cohort that included the data obtained from the 35 delegations that constitute the second level of medical attention for the month of December 2013. ResultsThere were 56,430 patients, 0.1% of the user population; 32,190 male (57%) and 24,240 females (43%), with an average age of 62 years (range, 18-90). The primary causes of CRF were diabetes, 29,661 (52.6%); high blood pressure, 19,862 (35.2%); and chronic glomerulopathy, 4,089 (7.2%). Of the total, 33,754 (60%) patients received peritoneal dialysis (PD) and 22,676 (40%), haemodialysis (HD). The highest prevalence was seen in Jalisco, the state of México Oriente and the southern Federal District, while the lowest was found in Campeche, southern Baja California and Zacatecas. General incidence was 124 cases per thousand users; the delegations with the highest incidence were Tlaxcala, Morelos and Hidalgo, while those of the lowest were Zacatecas, Sinaloa and the northern Federal District. The most frequent PD complications were peritonitis, fluid overload and mechanical catheter complications; the most frequent in HD were fluid retention, lack of hypertension control and hyperkalemia. Definitive exit in the 2 modes of dialysis were myocardial infarction, sepsis, heart failure and acid-base balance disorders. ConclusionsThese results constitute a referential framework and can provide the guidelines to initiate specific pathways of prevention, treatment and research. These will, in turn, make it possible to improve the quality of life of the patient undergoing dialysis and to optimise institutional resources.