The <scp>A</scp>rgentine <scp>S</scp>ociety of <scp>N</scp>ephrology and the history of end‐stage renal disease in <scp>A</scp>rgentina

The first hemodialysis in Argentina was performed in a private clinic by Dr Alfonso Guinazu of the University of Buenos Aires in 1955 using a Kolff-Brigham artificial kidney built locally. The Instituto Lanari in Buenos Aires was established in 1957 and in June of that year performed the first kidney transplant in the country and in April of the following year, having established a Nephrology and Dialysis Service, became the first public hospital in Argentina to do hemodialysis. As a result, several influential Argentinian physicians who were interested in kidney disease attended the First International Congress of Nephrology in Evian, France in 1960. The Argentine Society of Nephrology (SAN) was founded in 1960 and celebrated its 50th anniversary two years ago. The Society is well recognized both inside the Latin-American nephrology community and internationally. The first Argentine Congress of Nephrology was held in 1970, and in 1999, the 15th World Congress of Nephrology was held in Buenos Aires in conjunction with the society's Annual Congress, attracting more than 5000 attendees. Each year the Society develops both a Hemodialysis Course designed to educate and update the country's nephrologists and a similar Hemodialysis Course for nephrology nurses. Experience with these courses helps in selection of topics for the Argentine Congresses of Nephrology that are held every two years. In 2013, the 18th Argentine Congress of Nephrology and the 11th Argentine Congress for Nephrology Nurses will be held in conjunction with the 6th Congress of The International Society for Hemodialysis in Buenos Aires from September 11th to September 14th. In addition, articles are published and presentations about dialysis and transplantation by Argentinian physicians are given every year in Argentina, South America and worldwide. Chronic kidney disease is a major problem in Argentina just as it is elsewhere in the world and the principal causes are hypertension and diabetes. The Department of Health's National Survey of Factors of Risk shows that that 34.8% of the population aged 18 years or older has hypertension, and that between 2005 and 2009, the incidence of diabetes increased from 8% to 9.6% and that of obesity increased from 14.6% to 18.0% of the adult population. In addition, the general population is aging and this also predisposes to chronic kidney disease. Thus, a significant number of the population is at risk of developing kidney disease. While the reported incidence of the CKD has doubled in the last 10 years, there are many patients in the early stages that are undiagnosed and untreated. One recent national report suggests that about 12% of the adult population have some degree of renal disease. From 2004 onward, following an agreement between the SAN and the national agency coordinating transplantation, the Argentine Record of Chronic Dialysis was established. This is published annually on the Web page of the Society in both Spanish and English, and is available to nephrologists worldwide. In 2010, there were 6155 new dialysis patients and 25 patients whose first treatment was a kidney transplant, an overall incidence rate of 154.5 patients per million population (pmp), an increase of 1.36% over 2009. According to the Argentine Record of Chronic Dialysis, as of 2010, there were some 26,000 patient on dialysis, of whom 96% were on center hemodialysis and 4% were on peritoneal dialysis. Home hemodialysis was almost nonexistent. Preliminary data for 2012 suggest there are now 27,577 patients on dialysis, with 95% on center hemodialysis and 5% on peritoneal dialysis. Ninety percent of peritoneal dialysis patients are treated by continuous ambulatory peritoneal dialysis and the remainder by continuous cycling peritoneal dialysis. The annual increase in prevalent patients was between 6% and 8% for many years, but in the last four years, this growth seems to have weakened to about 3%. The recent national prevalence rate is 632 patients pmp. The results of dialysis for the treatment of end-stage renal disease are comparable to those of many other centers around the world. In terms of transplantation, in 2012, there was a total of 1067 kidney transplants consisting of 990 kidney transplants, 63 kidney and pancreas transplants, 11 kidney and liver transplants, and 3 kidney and heart transplants. There are important regional differences in the availability of kidney transplants in various regions of the country. The current waiting list has 5999 patients waiting for a kidney, 106 waiting for a kidney and pancreas, 23 waiting for a kidney and a liver, and 1 waiting for a kidney and a heart. Early recognition and treatment of renal disease may anticipate or delay its progression to more serious renal failure and its complications, particularly cardiovascular disease. Even so, the majority of the patients with renal disease in Argentina are not diagnosed until they present with symptoms of uremia. Consequently, there is a pressing need to educate physicians generally about the recognition and management of all stages of this disease in order to improve patient care and quality of life. The SAN actively collaborates with other national organizations that participate in improving the management of patients suffering from all chronic diseases. We hope to see many of you at the joint meeting of the International Society for Hemodialysis and the Argentine Congress of Nephrology and Congress for Nephrology Nurses in Buenos Aires from September 11th to September 14th.

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