RESUMEN
Objective The aim of this study was to determine the incidence of new patients requiring renal replacement therapy and to gather data on sex, age, ethnicity, mortality, and causes of kidney failure in Trinidad and Tobago in comparison with the rest of the world. Method Electronic data were gathered for new patients initiating dialysis between January 1, 2016, and December 31, 2017, including the date of dialysis initiation, age, gender, ethnicity, diagnosis, dialysis access and modality, and outcome at three months and the end of the year. The data were analyzed using simple descriptive statistics via Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States). Results Over a two-year period, 265 new patients underwent renal replacement therapy, of which 51.7% were 50-69 years of age, 53.9% were male, 46% were female, 67.9% were Afro-Trinidadian, and 38.1% had a combination of diabetes mellitus and hypertension as the cause of kidney failure. The incidence rates of treated end-stage renal disease (ESRD) globally in 2016 and 2017 were 306 and 224 per million population, respectively, and mortality for both years was 32% and 32.1%, respectively. Conclusion Our study showed that Trinidad and Tobago has one of the highest incidences of patients initiating renal replacement therapy and mortality rates.
RESUMEN
Calcific uremic arteriolopathy (CUA) or calciphylaxis is a rare condition that predominantly affects the dialysis population and is characterized by calcification of cutaneous arterioles accompanied by painful necrotic skin ulcers. At the hemodialysis unit of the Port-of-Spain General Hospital, there have been eight cases between the years 2015-2019 with an incidence of 121 cases per 10,000 patients undergoing renal replacement therapy, quite possibly one of the highest in the world along with an 87.5% mortality when diagnosed with this condition. Risk factors identified in this case series include female gender, obesity, and late presentation of end-stage renal disease. This case series highlights limitations in the diagnosis and management of the disease in a resource-limited setting and intends to raise awareness of this condition in the Caribbean.