In #PLOSOne: Annual cost only of dialysis exceeds 11% of the public health budget. To this we must add costs of hospitalization & treatment of comorbidities. Even still, not all CKD patients in #Ecuador have access to renal replacement therapy.
A 🧵
1/
doi.org/10.1371/journa…
A 🧵
1/
doi.org/10.1371/journa…
Not all provinces in #Ecuador have nephrologists while some only have them available in the private sector. Depending on their place of residence, patients may have to travel long distances to access dialysis services.
2/
2/
Comorbidities are common among CKD patients. Hospitalized patients had +2 comorbidities such as primary hypertension, type-II or type-I diabetes, other urinary tract disorders, heart failure & bacterial pneumonia.
3/
3/
“Hospitalization is an important reality for CKD patients”. Almost half of those with CKD were hospitalized for at least one day per year. In 2018, 3,427 CKD patients were hospitalized, for an average duration of 8.4 days.
4/
4/
Renal registres are needed:
Ecuador "lacks a patient registry to help health policymakers and administrators estimate the demand and progression of patients with consideration for comorbidities, disease stage, requirements and costs, mortality & follow-up.”
5/
Ecuador "lacks a patient registry to help health policymakers and administrators estimate the demand and progression of patients with consideration for comorbidities, disease stage, requirements and costs, mortality & follow-up.”
5/
#Ecuador must improve EARLY diagnosis: patients often present no/few symptoms in early stages -CKD is diagnosed too late, when they are hospitalized.
- Changes in medical education curricula/primary care guidelines, & professional training, are crucial to improving detection.
6/
- Changes in medical education curricula/primary care guidelines, & professional training, are crucial to improving detection.
6/
#Ecuador must:
- Increase awareness & knowledge of CKD & related NCDs.
- Build a comprehensive patient registry for adequate monitoring & follow up.
- Improve patient referral at the community level, to prevent & impede rapid progression of CKD.
7/
- Increase awareness & knowledge of CKD & related NCDs.
- Build a comprehensive patient registry for adequate monitoring & follow up.
- Improve patient referral at the community level, to prevent & impede rapid progression of CKD.
7/
- Conditions related to CKD such as overweight and obesity should be addressed through public health measures,
- Integrating interventions in development programs & community-based health promotion should be considered.
8/
- Integrating interventions in development programs & community-based health promotion should be considered.
8/
Since chronic kidney disease of unknown origin (CKDu), or Mesoamerican nephropathy, has emerged as a major health concern in populations with similar labor conditions to coastal #Ecuador, future research is needed to determine whether CKDu is present.
9/
9/
• • •
Missing some Tweet in this thread? You can try to
force a refresh
