- There is no official census but it is estimated that at least 12 million people in Mexico suffer from Chronic Kidney Disease (CKD),
- For 2030, a prevalence of 643 million people with diabetes is projected in the world, of which 20% will develop CKD.
- General practitioners are useful to identify signs of this type of pathology and refer to a nephrologist.
Although there are people who tend to minimize the work of general practitioners, they are actually doctors who fulfill a very important function. These are the first contact personnel who deal with thousands of queries of the most diverse types on a daily basis. For this reason, it is necessary to know a little about everything in order to offer a diagnosis to the patient or refer them to the appropriate specialist.
Medical students are often led to believe that their “obligation” is to present the ENARM to study a specialty at the end of the degree, although this is not necessarily the case. All postgraduate studies must be on your own initiative and not to please others.
Now, a common phrase that is mentioned is that “Prevention is better than cure.” For this principle to be fulfilled, the participation of general practitioners is required because they are a pillar within the health system of any country.
Chronic Kidney Disease, a growing public health problem
According to data from the Ministry of Health (SSa), more than 12 million people in Mexico have Chronic Kidney Disease (CKD), which is cataloged within the main causes of death among the population. One of the problems is that there are estimates but not an exact calculation of how many people have it because there has simply never been a census.
The institutions of the health sector have an approximate number, but the lack of hard data persists”, stated the doctor Alberto RosasNephrologist, Director of the transplant program at the Secretary of Health of the State of Guerrero.
He recalled that CKD affects an average of 13 million people around the world and shared the following data:
- According to data from the SSa, in 2017 approximately 59% of CKD cases were secondary to diabetes.
- According to the 2018 National Health and Nutrition Survey (ENSANUT), the prevalence of CKD in adults over 20 years of age in Mexico was 13.9%.
- In the country, CKD is one of the main causes of death, along with diabetes and cardiovascular diseases, according to data from the Ministry of Health.
- CKD is responsible for 10% of deaths in patients requiring hospitalization, and 7% of deaths in the general population in Mexico.
- Diabetes is the leading cause of CKD in Mexico, and it is estimated that around 20% of people with type 2 diabetes in the country will develop CKD at some point in their lives.
- Arterial hypertension is another of the main causes of CKD in Mexico, in fact, it is estimated that 30% of people with hypertension will develop CKD at some point.
- Only 10% of CKD patients who need dialysis have access to it.
- The average monthly cost of treating a CKD patient in Mexico is around $35,000.00.
The role of first contact physicians
Despite the importance of CKD in public health in Mexico, there are many challenges for its correct diagnosis and treatment. Many patients have no symptoms in the early stages of the disease, making early detection difficult. In addition, access to high-quality, specialized health services is limited in some regions of the country, which can delay proper diagnosis and treatment.
Dr. Rosas acknowledges that from the government and, specifically, from the health institutions, more preventive actions need to be taken. In other countries, such as Brazil, daily physical activity programs have been implemented, in addition to taking great care of diet, despite the fact that the market is full of high-calorie products, full of sodium and sugar.
For his part, Dr. Gilberto Castañeda, a researcher at CINVESTAV of the IPN who was one of the trainers during the Mega Summit, commented that Laboratorios Columbia is promoting the training of first contact doctors at the level of the Mexican Republic, in order to provide education continuous medical attention on CKD and, thus, increase its timely detection.
“It is they, the first contact doctors, who are in the first line of health care in our country. For this reason, we insist, the scrutiny carried out by first-contact doctors is very important when identifying CKD in earlier stages, and in this context, strategies should begin to be established focused on the factors of CKD progression. For example, in patients with diabetes, metabolic decontrol is very common”.
It is necessary to remember that, with CKD, even in stage three, patients are practically asymptomatic, so they are not aware that they have a problem.
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