RT Journal Article
SR Electronic
T1 Treatment of end-stage renal disease with continuous ambulatory peritoneal dialysis in rural Guatemala
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-223641
DO 10.1136/bcr-2017-223641
VO 2018
A1 Jillian Moore
A1 Pablo Garcia
A1 Peter Rohloff
A1 David Flood
YR 2018
UL http://casereports.bmj.com/content/2018/bcr-2017-223641.abstract
AB A 42-year-old indigenous Maya man presented to a non-profit clinic in rural Guatemala with signs, symptoms and laboratory values consistent with uncontrolled diabetes. Despite appropriate treatment, approximately 18 months after presentation, he was found to have irreversible end-stage renal disease (ESRD) of uncertain aetiology. He was referred to the national public nephrology clinic and subsequently initiated home-based continuous ambulatory peritoneal dialysis. With primary care provided by the non-profit clinic, his clinical status improved on dialysis, but socioeconomic and psychological challenges persisted for the patient and his family. This case shows how care for people with ESRD in low- and middle-income countries requires scaling up renal replacement therapy and ensuring access to primary care, mental healthcare and social work services.