Registry of diabetic kidney disease in the primary health care. Cuba 2014

Abstract

Introduction: The basis of Cuban National Health System lies in the Family Doctors who register, evaluate the risks, treat, and follow-up patients with chronic diseases. Diabetes Mellitus(DM) is the main cause of advanced chronic kidney disease (CKD), and these patients are also identified and treated all over the country.

Objectives: To characterize the CKD and the CKD + DM according to their registries in the Primary Health Care Centers.
Material and methods: Patients with CKD caused by diabetes (glomerular filtration rate <60 mL/min/1,73 m²) who were registered in Cuba in the year 2015; with reported prevalence per 1 000 inhabitants; and also characterized according to sex, age, province, and nation. The primary data were taken from the Registries of the National Direction of Statistics. 
Results: The national prevalence of CKD was 2,16 per 1 000 inhabitants (increase of 17,7 vs 2014), and the prevalence of CKD + DM was 0,48 per 1 000 inhabitants (increase of 25,9 vs 2014). There was an increase at older age, and reached a maximum value in the group of ages from 60-64 years, both for the CKD (11,4 x 1 000) and the CKD + DM (2,92 x 1 000).  Out of the total of patients with CKD, the diabetic ones represented the 12,7% in 2014, and the 13,6% in 2015, with a higher frequency in the female sex in both years (2014=12,7%, and 2015=14,4%). The prevalence in patients with CKD, and the proportion of patients with CKD + DM was lower than the one reported by the Third National Survey on Risk Factors.  
Conclusions: CKD is underdiagnosed in the country, and the same thing happens with CKD + DM, but even in a higher degree. The implementation of effective actions is required for the early diagnosis of the patients in the Primary Health Care.

Keywords: prevalence,chronic renal insufficiency, Advanced Chronic Renal Disease, Primary Health Care Centers