{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:16:18Z","timestamp":1788189378432,"version":"build-2803163510"},"reference-count":38,"publisher":"Pan American Health Organization","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<title>RESUMEN<\/title>\n                  <sec>\n                    <title>Objetivo.<\/title>\n                    <p>Describir la situaci\u00f3n epidemiol\u00f3gica y asistencial de la enfermedad renal cr\u00f3nica avanzada (ERCA) y terminal (ERCT) en Am\u00e9rica Latina, identificar fortalezas y brechas en la detecci\u00f3n temprana, la derivaci\u00f3n, el acceso y la cobertura de las terapias de reemplazo renal (TRR), contextualizar los hallazgos ante la reciente resoluci\u00f3n WHA78.6 aprobada por la Asamblea Mundial de la Salud sobre salud renal y proponer recomendaciones.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>M\u00e9todo.<\/title>\n                    <p>Se elabor\u00f3 un informe especial con un enfoque narrativo estructurado, basado en un an\u00e1lisis descriptivo y comparativo de fuentes secundarias regionales y globales de los \u00faltimos seis a\u00f1os. La informaci\u00f3n se organiz\u00f3 en cuatro ejes: 1) detecci\u00f3n y derivaci\u00f3n oportunas, 2) acceso y costos de las TRR, 3) mortalidad e inequidades estructurales, y 4) disponibilidad y calidad de los registros nacionales.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Resultados.<\/title>\n                    <p>Am\u00e9rica Latina presenta una elevada prevalencia de ERC y una mortalidad asociada a ERCA superior al promedio global, con marcadas inequidades, deficiencias en la derivaci\u00f3n oportuna a nefrolog\u00eda y una alta proporci\u00f3n de inicios no planificados de di\u00e1lisis. La hemodi\u00e1lisis predomina ampliamente sobre la di\u00e1lisis peritoneal y el trasplante renal, pese a que este \u00faltimo es la modalidad m\u00e1s costoefectiva y con mejores resultados en sobrevida y calidad de vida. Existen limitaciones en la cobertura financiera y en la disponibilidad de registros nacionales integrales.<\/p>\n                  <\/sec>\n                  <sec>\n                    <title>Conclusiones.<\/title>\n                    <p>Los hallazgos evidencian fallas estructurales persistentes en la atenci\u00f3n renal en Am\u00e9rica Latina y, en paralelo, permiten establecer recomendaciones concretas y priorizadas. La evidencia analizada fundamenta la necesidad de fortalecer la gobernanza en salud renal, mejorar la detecci\u00f3n y la referencia oportunas, garantizar un acceso equitativo y sostenible a las TRR, priorizar estrat\u00e9gicamente el trasplante renal y consolidar sistemas de informaci\u00f3n interoperables, como base para reducir la mortalidad e inequidades en la regi\u00f3n.<\/p>\n                  <\/sec>","DOI":"10.26633\/rpsp.2026.65","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T14:28:42Z","timestamp":1788186522000},"page":"1","source":"Crossref","is-referenced-by-count":0,"title":["Enfermedad renal cr\u00f3nica avanzada y terminal en Am\u00e9rica Latina: brechas en el continuo de atenci\u00f3n, papel estrat\u00e9gico del trasplante renal y retos para la gobernanza en salud"],"prefix":"10.26633","volume":"50","author":[{"given":"Natalia","family":"Grinblat","sequence":"first","affiliation":[{"name":"Organizaci\u00f3n Panamericana de la Salud, Washington, D. 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