Skip to main content

Nephrology in Uruguay

  • Chapter
  • First Online:
Nephrology Worldwide

Abstract

Uruguay (República Oriental del Uruguay) is a South American country (3,505,985 inhabitants, area of 176,215 Km2) where renal replacement therapy for end-stage renal disease has been available for the entire population since 1980. The National Kidney Biopsy Registry was implemented in 1985, the National Renal Healthcare Program providing multidisciplinary care to improve the diagnosis and treatment of patients with chronic renal disease initiated in 2004, and in 2007 the National Integrated Health System (Sistema Nacional Integrado de Salud or SNIS for its Spanish acronym) was established. Nephrological care is widely available for the entire population. Acute and chronic hemodialysis, peritoneal dialysis, and kidney transplantations are available throughout the country. All these treatments are under permanent quality control by health authorities. The Uruguayan Society of Nephrology and the National Resources Fund hold a mandatory registry on dialysis, whereas the Uruguayan Society of Transplantation maintains the Kidney Transplant Registry that includes all kidney transplants performed in the country. In Uruguay, there are 175 practicing nephrologists, 38 hemodialysis centers, 8 peritoneal dialysis centers, and 3 renal transplantation teams. In 2018, the prevalence of dialysis patients was 771 pmp (3069 on hemodialysis and 296 on peritoneal dialysis), and 461 pmp are living with a functioning kidney graft.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Franchi-Padé H. Enfermedades médicas de los riñones. Montevideo: Ed Científica del SMU, 1942. 2 vols. Available from: https://www.smu.org.uy/publicaciones/libros/historicos/emr-1/ and https://www.smu.org.uy/publicaciones/libros/historicos/emr-2/.

  2. Franchi-Padé H. La multi-instantanée fonctionnelle du rein. La Semaine des Hopitaux de Paris. 1954;30(3):E172–81.

    Google Scholar 

  3. Mazzuchi N, Acosta N, Caorsi H, Schwedt E, Di Martino LA, Mautone M, Gadola L, Petraglia A, Noboa O. Programa de Prevención y Tratamiento de las Glomerulopatías. Frequency of diagnosis and clinic presentation of glomerulopathies in Uruguay. Nefrologia. 2005;25(2):113–20.

    CAS  PubMed  Google Scholar 

  4. Lombardi R, et al. Diálisis peritoneal. El Día Médico Uruguayo. 1973;XI(476):262–6.

    Google Scholar 

  5. Fernández A, Espasandín W, Petruccelli D. Tratamiento de la insuficiencia renal aguda. Montevideo: Facultad de Medicina; 1962.

    Google Scholar 

  6. Petruccelli D, Llopart T, Corio E, Turnes A. Recuerdos de los comienzos de la Nefrología en Uruguay. Montevideo: Ed Tradinco; 2009.

    Google Scholar 

  7. Petruccelli D. Informe sobre trasplantes. Arch Med Intern. 1985;VII(1–4):45–8.

    Google Scholar 

  8. Ambrosoni P. Uruguay (Nefrología). Nefrologia. 1992;XII(Supl 3):52–61.

    Google Scholar 

  9. González-Bedat MC, Ferreiro Fuentes A, Chifflet Bide L, Ceretta ML. Registro Uruguayo de Diálisis: Informe anual 2016. Montevideo: RUD. 2018. http://nefrouruguay.org.uy/wp-content/uploads/2014/01/informeRUD2016.pdf. Accessed 2 June 2019.

  10. Fondo Nacional de Recursos. Unidad de Registros Médicos. Informe anual de diálisis crónica: año. 2018. Montevideo. https://www.fnr.gub.uy/sites/default/files/estadisticas/ia2018/ia_dial_2018.pdf. Accessed 2 June 2019.

  11. Orihuela S, Curi L, Nin M, Manzo L, Gonzalez G, Nuñez N, Kurdian M, Cuñeti L, Larre-Borges P, González-Martínez F. First 1500 kidney transplants at the Institute of Nephrology and Urology in Uruguay: analysis of the results. Transplant Proc. 2016;48(2):616–9.

    Article  CAS  PubMed  Google Scholar 

  12. Schwedt E, Solá L, Ríos PG, Mazzuchi N, National Renal Healthcare Program. Improving the management of chronic kidney disease in Uruguay: a National Renal Healthcare Program. Nephron Clin Pract. 2010;114(1):c47–59. https://doi.org/10.1159/000245069.

    Article  PubMed  Google Scholar 

  13. Mazzuchi N, Schwedt E, Solá L, González C, Ferreiro A. Risk factors and prevention of end stage renal disease in Uruguay. Ren Fail. 2006;28:617–25.

    Article  PubMed  Google Scholar 

  14. Mazzuchi N, Rios P, Canzani O, De Souza N, Gadola L, Lamadrid V, Sola L. Impacto del control clínico en el Programa de Salud Renal en la supervivencia de pacientes. Fondo Nacional de Recursos. Publicaciones científicas. Accessed 2 June 2019. http://www.fnr.gub.uy/trabajos_cientificos_psr.

  15. Ríos P, Schwedt E, Solá L, Gadola L, De Souza N, Lamadrid V. Importance of preventive medical examination for early diagnosis of renal disease in Uruguay - the National Renal Health Program. Arch Med Interna. 2015;37(3):114–21.

    Google Scholar 

  16. Schwedt E, Solá L, Ríos PG, Mazzuchi N. Improving the management of chronic kidney disease in Uruguay: a National Renal Healthcare Program. Nephron Clin Pract. 2010;114:c47–59.

    Article  PubMed  Google Scholar 

  17. Ríos-Sarro P, Sola L, Gadola L. Prevalence of CKD in Uruguay. In: García-García G, Agodoa LY, Norris KC, editors. Chronic kidney disease in disadvantaged populations. London: Academic Press; 2017. p. 35–44. https://doi.org/10.1016/B978-0-12-804311-0.00005-4.

    Chapter  Google Scholar 

  18. Subiza AK, Odriozola M, Ríos P, Lamadrid V, Mazzuchi N, Gadola L. Riesgo cardiovascular en enfermedad renal crónica. Rev Urug Cardiol. 2016;31:206–18.

    Google Scholar 

  19. Guía de Práctica clínica en el tratamiento de las glomerulopatías. Gadola L, Noboa O, Otatti G, Cabrera MJ, González-Martinez F, Caorsi H. Ed Cuadrado, 2018, Uruguay. ISBN 978-9974-8564-2-4.

    Google Scholar 

  20. Garau M, Cabrera J, Ottati G, Caorsi H, Gonzalez Martinez F, Acosta N, Aunchayna MH, Gadola L, Noboa O. PLoS One. 2018;13(10):e0206637. https://doi.org/10.1371/journal.pone.0206637.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Urrestarazu A, Figueroa S, Coitiño R, Coria V, Acosta N, Aunchayna MH, Garau M, Gadola L. Nefropatías tubulointersticiales no obstructivas biopsiadas en Uruguay. Nefrología Latinoamericana. 2017;14(4):144–52. https://doi.org/10.1016/j.nefrol.2017.06.001.

    Article  Google Scholar 

  22. Boggia J, Luzardo L, Lujambio I, Sottolano M, Robaina S, Thijs L, Olascoaga A, Noboa O, Struijker-Boudier HA, Safar ME, Staessen JA. The diurnal profile of central hemodynamics in a general Uruguayan population. Am J Hypertens. 2016;29(6):737–46. https://doi.org/10.1093/ajh/hpv169.

    Article  PubMed  Google Scholar 

  23. Tenzi J, Ferreiro A, Lombardi L, Schwedt E, Nin N, Cancela M, González F. Injuria renal aguda en medicina intensiva. Encuesta multicéntrica nacional. Paciente crítico. 2009;19:9–16.

    Google Scholar 

  24. Llopart T, Lombardi R, Forselledo M, et al. Acute renal failure in open heart surgery. Ren Fail. 1997;19:319–23.

    Article  CAS  PubMed  Google Scholar 

  25. Lombardi R, Ferreiro A. Risk factor profile for acute kidney injury after cardiac surgery is different according to the level of baseline renal function. Ren Fail. 2008;30:155–60.

    Article  PubMed  Google Scholar 

  26. Masquil D, Ferreiro A. Epidemiología, curso e indicadores pronósticos de la injuria renal aguda en la unidad de cuidados intensivos. Abstract in XIII Congreso Latinoamericano de Nefrología. Sociedad Latinoamericana de Nefrología. Lima. Setiembre 2019. https://slanh.net/congreso-slanh-2019-lima-peru/. Accessed 18 Dec 2019.

  27. Lombardi R. Acute renal failure in leptospirosis in Uruguay. Ren Fail. 1997;19(2):315–8.

    Article  CAS  PubMed  Google Scholar 

  28. Lombardi R, Ferreiro A, Rosa-Diez G. Raising awareness of acute kidney injury: a Latin American experience. Kidney Int Rep. 2018;3(6):1416–23. https://doi.org/10.1016/j.ekir.2018.08.003.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Uruguay. Ministerio de Salud. Ordenanza número 89/2014 del Ministerio de Salud: Protocolo de preparación de pacientes que recibirán medios de contraste. Montevideo. 2014. https://www.gub.uy/ministerio-salud-publica/sites/ministerio-salud-publica/files/2019-02/Ord.%20Min.%20N°%2089%20y%20Anexos.pdf. Accessed 9 June 2019.

  30. Ferreiro A, Lombardi R. Acute kidney injury after cardiac surgery is associated with mid-term but not long-term mortality: a cohort-based study. PLoS One. 2017;12(7):e0181158. https://doi.org/10.1371/journal.pone.0181158.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Llopart T, González F, Alvarez A, Alvarez I, Fernández JM, Nin J, Schwedt E, Ambrosoni P, Mazzuchi N. Situación de la hemodiálisis crónica en el Uruguay. Rev Med Urug. 1986;2:90–4.

    Google Scholar 

  32. Schwedt E, Fernández J, González F, Ambrosoni P, Mazzuchi N. Diez años de hemodiálisis en Uruguay. Condiciones de ingreso, características del tratamiento y resultados. Nefrologia. 1993;13(Suppl 4):20–9.

    Google Scholar 

  33. Fernández J, Schwedt E, Ambrosoni P, González F, Mazzuchi N. Eleven years of chronic hemodialysis in Uruguay: mortality time course. Kidney Int. 1995;47:1721–75.

    Article  PubMed  Google Scholar 

  34. Mazzuchi N, Fernández-Cean JM, Schwedt E, González-Martínez F, et al. Registro Latinoamericano de Diálisis y Trasplante. Informe 1998. Nefrología latinoamericana. 1998;5:105–59.

    Google Scholar 

  35. González-Bedat MC, Rosa-Diez G. Registro Latinoamericano de Diálisis y Trasplante Renal: Informe 2015–2016. http://test1.slanh.net/wp-content/uploads/2018/10/INFORME-2015-2016.pdf. Accessed 2 June 2019.

  36. González C, coord. Registro Uruguayo de Diálisis. Incidencia anual de diálisis 1981–2018. http://nefrouruguay.org.uy/wp-content/uploads/2019/03/INCIDENCIA-PREVALENCIA-1981-2018.pdf. Accessed 2 June 2019.

  37. United States Renal Data System. 2018 USRDS annual data report: epidemiology of kidney disease in the United States. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2018.

    Google Scholar 

  38. González C, Fernández-Cean J, González-Martínez F, Schwedt E, Mazzuchi N. Chronic dialysis in Uruguay: mortality trends from 1981 to 1998. Nefrologia. 2001;21(4):342–8.

    PubMed  Google Scholar 

  39. Uruguay. Ministerio de Salud Pública. Sistema Nacional Integrado de Salud. Montevideo, s.d. https://www.gub.uy/ministerio-salud-publica/politica-y-gestion/sistema-nacional-integrado-salud. Accessed 2 June 2019.

  40. Molins S, Alonso L, Fernández J. Uruguay: El plan integral de atención a la salud. In: Gideon U, Biltrán R, Ignez T, editors. Planes de beneficios en salud en América Latina: una comparación regional. Washington, DC: BID; 2014. p. 115–43.

    Google Scholar 

  41. World Health Organization. Global health expenditure database. Geneva. 2019. https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS. Accessed 2 June 2019.

  42. Uruguay. Fondo Nacional de Recursos ¿Qué es el Fondo Nacional de Recursos? Montevideo. n.d. http://www.fnr.gub.uy/que_es_fnr. Accessed 2 June 2019.

  43. Uruguay. Fondo Nacional de Recursos. Misión, visión, valores y principios. Montevideo. n.d. http://www.fnr.gub.uy/mision. Accessed 2 June 2019.

  44. Uruguay. Fondo Nacional de Recursos. Organización institucional. Montevideo. n.d. http://www.fnr.gub.uy/organizacion_institucional. Accessed 2 June 2019.

  45. Uruguay. Fondo Nacional de Recursos. Información económica y financiera. Montevideo. n.d. http://www.fnr.gub.uy/info_economico_financiera. Accessed 2 June 2019.

  46. Uruguay. Fondo Nacional de Recursos. Aranceles 2019. Montevideo. n.d. http://www.fnr.gub.uy/sites/default/files/finanzas/aranceles/aranceles_2019.pdf. Accessed 2 June 2019.

  47. Uruguay. Fondo Nacional de Recursos. Técnicas. Montevideo. n.d. http://www.fnr.gub.uy/tecnicas. Accessed 2 June 2019.

  48. Uruguay. Fondo Nacional de Recursos. Tratamiento con Medicamentos. Montevideo. n.d. http://www.fnr.gub.uy/tratamientos_con_medicamentos. Accessed 2 June 2019.

  49. Uruguay. Fondo Nacional de Recursos. Programa de Salud Renal. Montevideo. n.d. http://www.fnr.gub.uy/home_psaludrenal. Accessed 2 June 2019.

  50. Uruguay. Fondo Nacional de Recursos. Resultados. Montevideo. n.d. http://www.fnr.gub.uy/resultados. Accessed 2 June 2019.

  51. Uruguay. Fondo Nacional de Recursos. Resultados Hemodiálisis: Año 2017. Montevideo. n.d. http://www.fnr.gub.uy/resultados_hemodialisis_2017. Accessed 2 June 2019.

  52. Uruguay. Fondo Nacional de Recursos. Estándares de evaluación y seguimiento para la mejora de calidad de los IMAE. 2nd ed. Montevideo: FNR. Publicación Técnica N° 20. 2012. http://www.fnr.gub.uy/sites/default/files/libro_mejora_calidad_139_web.pdf. Accessed 2 June 2019.

  53. Uruguay. Fondo Nacional de Recursos. Tratamiento dialítico. Normativa de cobertura FNR. Montevideo: julio 2006. http://www.fnr.gub.uy/sites/default/files/normativas/tecnicas/n_dialisis.pdf. Accessed 2 June 2019.

  54. Uruguay. Fondo Nacional de Recursos. Guías para el diseño de la Unidad de Hemodiálisis. Montevideo: nov. 2007. http://www.fnr.gub.uy/sites/default/files/publicaciones/FNR_GuiaDeHemodialisis.pdf. Accessed 2 June 2019.

  55. Aguirrezábal X, Bazet C, Beltrán L, Blanco J, Castillo T, Díaz L, et al. Guías de gestión de calidad del agua para diálisis. Montevideo: FNR. n.d. http://www.fnr.gub.uy/sites/default/files/publicaciones/FNR_guia_dialisis.pdf. Accessed 2 June 2019.

  56. Blanco JC, Leiva G, Castillo T, Nin M, Chifflet L, Opertti A, et al. Guías de gestión de calidad del agua para diálisis. 2° ed. Montevideo: FNR, 2014. http://fnr.gub.uy/sites/default/files/publicaciones/FNR_guia_dialisis_2014.pdf. Accessed 2 June 2019.

  57. Mazzuchi N, Carbonell E, Fernández-Cean J. Importance of blood pressure control in hemodialysis patient survival. Kidney Int. 2000;58(5):2147–54.

    Article  CAS  PubMed  Google Scholar 

  58. Gadola L, Gomez T, Saez L, et al. Diez años del registro uruguayo de peritonitis en diálisis peritoneal. Rev Med Urug. 2016;32(3):87–98.

    Google Scholar 

  59. Gadola L, Poggi C, Poggio M, Sáez L, Ferrari A, Romero J, Fumero S, Ghelfi G, Chifflet L, Borges PL. Using a multidisciplinary training program to reduce peritonitis in peritoneal dialysis patients. Perit Dial Int. 2013;33(1):38–45. https://doi.org/10.3747/pdi.2011.00109.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Gadola L, Poggi C, Dominguez P, Poggio MV, Lungo E, Cardozo C. Risk factors and prevention of peritoneal dialysis-related peritonitis. Perit Dial Int. 2019;39(2):119–25. https://doi.org/10.3747/pdi.2017.00287.

    Article  PubMed  Google Scholar 

  61. González-Martínez F, Orihuela S, Alvarez I, Dibello N, Curi L, Nin M, Wimber E, Mizraji R, Bengochea M, González G, Manzo L, Toledo R, Silva W, Chopitea A, Lopez D, Balboa O, Porto D, Noboa O. Development of the national kidney transplantation program in Uruguay. Transplant Proc. 2015;47(8):2336–9.

    Article  PubMed  Google Scholar 

  62. Duro García V, Santiago-Delpín E, Tanus R. Latin America transplantation registry report 2015–2016. Np: STALYC. n.d. https://www.stalyc.net/registros/file/74-latin-america-transplantation-registry-report-2015-2016.html. Accessed 2 June 2019.

  63. Uruguay. Fondo Nacional de Recursos. Visualizador de actos médicos realizados. 2018. Montevideo. n.d. http://www.fnr.gub.uy/visualizador_realizaciones_2018 Accessed 2 June 2019.

  64. Olaizola I, Aznarez A, Jorgetti V, Petraglia A, Caorsi H, Acuña G, Fajardo L, Ambrosoni P, Mazzuchi N. Are there any differences in the parathyroid response in the different types of renal osteodystrophy? Nephrol Dial Transplant. 1998;13(3):15–8.

    Article  PubMed  Google Scholar 

  65. Ambrosoni P, Olaizola I, Heuguerot C, Parodi MN, Caorsi H, Caputti S, López J, Di Trápani N, Petraglia A. The role of imaging techniques in the study of renal osteodystrophy. Am J Med Sci. 2000;320(2):90–5.

    Article  CAS  PubMed  Google Scholar 

  66. Grunberg J. Historia de la nefrología pediátrica uruguaya. 1904–2007. Arch Med Int. 2007;XXIX(4):110–2.

    Google Scholar 

  67. Universidad de la República. Escuela de Graduados de la Facultad de Medicina. Montevideo: sd. http://www.egradu.fmed.edu.uy/sites/www.egradu.fmed.edu.uy/files//Programa_de_postgrados/Especialidades/NEFROLOGÍA%20PEDIÁTRICA.pdf. Accessed 2 June 2019.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gadola, L. et al. (2021). Nephrology in Uruguay. In: Moura-Neto, J.A., Divino-Filho, J.C., Ronco, C. (eds) Nephrology Worldwide. Springer, Cham. https://doi.org/10.1007/978-3-030-56890-0_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-56890-0_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-56889-4

  • Online ISBN: 978-3-030-56890-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics