<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0211-6995</journal-id>
<journal-title><![CDATA[Nefrología (Madrid)]]></journal-title>
<abbrev-journal-title><![CDATA[Nefrología (Madr.)]]></abbrev-journal-title>
<issn>0211-6995</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Nefrología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0211-69952016000600517</article-id>
<article-id pub-id-type="doi">10.1016/j.nefro.2016.03.018</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Incidencia, mortalidad y prevalencia de enfermedad renal crónica terminal en la región del Bajo Lempa, El Salvador: 10 años de registro comunitario]]></article-title>
<article-title xml:lang="en"><![CDATA[Incidence, mortality, and prevalence of end-stage chronic renal disease in the Bajo Lempa region of El Salvador: A ten-year community registry]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Trabanino]]></surname>
<given-names><![CDATA[Ramón]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rosa]]></surname>
<given-names><![CDATA[Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domínguez Alonso]]></surname>
<given-names><![CDATA[Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Nacional Rosales Departamento de Investigación Comité científico]]></institution>
<addr-line><![CDATA[San Salvador ]]></addr-line>
<country>El Salvador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Fondo Social de Emergencia para la Salud  ]]></institution>
<addr-line><![CDATA[Usulután Cantón Tierra Blanca]]></addr-line>
<country>El Salvador</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Ministerio de Salud Sistema Básico de Salud Integral (SIBASI) ]]></institution>
<addr-line><![CDATA[Usulután ]]></addr-line>
<country>El Salvador</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Salvadoreño del Seguro Social (ISSS) Unidad médica Puerto El Triunfo ]]></institution>
<addr-line><![CDATA[Usulután ]]></addr-line>
<country>El Salvador</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Área Sanitaria Jaén Nordeste Atención Primaria ]]></institution>
<addr-line><![CDATA[Jaén Andalucía]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2016</year>
</pub-date>
<volume>36</volume>
<numero>5</numero>
<fpage>517</fpage>
<lpage>522</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0211-69952016000600517&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0211-69952016000600517&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0211-69952016000600517&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El Bajo Lempa es una región rural costera pobre de El Salvador afectada por la epidemia de enfermedad renal crónica (ERC) denominada nefropatía mesoamericana. La organización local comunitaria Fondo Social de Emergencia para la salud (FSES) colabora contra la epidemia en 42 comunidades de la región (19.223 habitantes; edad promedio 26,7 años; 48,5% masculino; 40,2% &lt; 18 años).  Objetivos: Reportar tasas anuales de incidencia de ERC terminal (ERCT) y de mortalidad de pacientes en estas comunidades durante 10 años (2004-2013), más la prevalencia de pacientes en tratamiento sustitutivo renal (TSR) al 31 de diciembre del 2013.  Métodos: El FSES registró casos nuevos de ERCT, sus antecedentes básicos, la modalidad de TSR recibida y sus fallecimientos.  Resultados: Registramos 271 nuevos casos de ERCT (promedio anual 27,1; 89% masculino; edad promedio 55,6 años; 4 &lt; 18 años). Tasa de incidencia de ERCT anual promedio: 1.409,8 por millón de población (pmp). Un 66% no reportaba diabetes ni hipertensión. Recibieron TSR 94 (34,7%) pacientes: 58 en el Ministerio de Salud, 26 en servicios privados, 9 en la seguridad social y uno en la sanidad militar. Fallecieron 246 (promedio anual 24,6; 89,4% masculino; edad promedio 56,1 años; 92,3% en su domicilio). Tasa de mortalidad anual promedio: 128/100.000 habitantes. Prevalencia de pacientes en TSR al 2013: 1.300,5 pmp (N = 25; 84% masculino; edad promedio 51 años).  Conclusiones: En esta región la incidencia de ERCT es elevada. Pocos reciben TSR. La mortalidad es alta, aun con TSR. Son mayormente varones adultos (9:1). Los determinantes sociales inciden en la alta mortalidad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The Bajo Lempa is an impoverished rural coastal region of El Salvador affected by the chronic kidney disease (CKD) epidemic known as Mesoamerican nephropathy. The local community organisation Fondo Social de Emergencia para la Salud (FSES) (Emergency social fund for health) is helping to fight the epidemic in 42 communities of the region (19,223 inhabitants; average age 26.7 years; 48.5% male; 40.2% &lt;18 years).  Objectives: To report annual rates of end-stage renal disease (ESRD) incidence and patient mortality in these communities during a 10-year period (2004-2013), and the prevalence of patients receiving renal replacement therapy (RRT) as of 31 December 2013.  Methods: The FSES recorded new ESRD cases, basic patient history, form of RRT if received and patient deaths.  Results: We registered 271 new ESRD cases (annual average 27.1; 89% male; average age 55.6 years, four &lt;18 years). Average annual ESRD incidence rate: 1409.8 per million population (pmp). Two-thirds did not report diabetes or hypertension. 94 patients (34.7%) received RRT: 58 in the Ministry of health, 26 in private services, 9 in social security and 1 in the military health system. 246 patients died (annual average 24.6 deaths; 89.4% male; average age 56.1 years; 92.3% at home). Average annual mortality rate: 128/100,000 population. Prevalence of patients receiving RRT in 2013: 1300.5 pmp (N = 25; 84% male; average age 51 years).  Conclusions: This region has a high incidence of ESRD. Few receive RRT. Patient mortality is high even with RRT. Most patients are male (9:1). Social determinants influence the high mortality.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Bajo Lempa]]></kwd>
<kwd lng="es"><![CDATA[El Salvador]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad renal crónica]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad renal crónica terminal]]></kwd>
<kwd lng="es"><![CDATA[Incidencia]]></kwd>
<kwd lng="es"><![CDATA[Mortalidad]]></kwd>
<kwd lng="es"><![CDATA[Nefropatía mesoamericana]]></kwd>
<kwd lng="es"><![CDATA[Prevalencia]]></kwd>
<kwd lng="es"><![CDATA[Tratamiento sustitutivo renal]]></kwd>
<kwd lng="en"><![CDATA[Bajo Lempa]]></kwd>
<kwd lng="en"><![CDATA[El Salvador]]></kwd>
<kwd lng="en"><![CDATA[Chronic kidney disease]]></kwd>
<kwd lng="en"><![CDATA[End-stage renal disease]]></kwd>
<kwd lng="en"><![CDATA[Incidence]]></kwd>
<kwd lng="en"><![CDATA[Mortality]]></kwd>
<kwd lng="en"><![CDATA[Mesoamerican nephropathy]]></kwd>
<kwd lng="en"><![CDATA[Prevalence]]></kwd>
<kwd lng="en"><![CDATA[Renal replacement therapy]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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