Uruguay
Uruguay
Uruguay is a nation and team of firsts: the first host of the FIFA World Cup and the first to win the World Cup. A stellar history that has few comparators. Today, the team boasts four stars in their uniform, signifying the four times they were world champions. Watching them play is like watching colossal warriors that defend their field with fang and teeth; their attack is swift and lethal.
Their history is perhaps only matched by their thirst for another title (last in 1950). Despite the long championship drought, their style of play steals the heart of many, and their passion and respect for the sport have awarded them international glory.
They have gifted the world with one of the most longstanding stalwarts of football. Nicknamed The Maestro, Oscar Washington Tavares has the longest serving tenure with one team in World Cup history. He finished his career as a coach in November of 2021 after being behind the wheel for an astonishing 15 years.
Figure 1. The state of kidney disease in Uruguay
With history, discipline, and a thirst for more, Uruguay enters the NephroWorldCup Tournament with a review of the current state of nephrology in the country. Dialysis has been offered to the Uruguayan population since the 1980s. It's not until 2007 that Uruguay developed an integrated integrated healthcare system, offering dialysis treatment to the entire population (Figure 1).
Despite the above, many challenges still remain, according to the article Uruguay has 175 practicing nephrologists, 38 hemodialysis centers, 8 peritoneal dialysis centers, and 3 kidney transplant teams.
Uruguayans have found that incorporating data is an important asset in their fight against kidney disease. Since the creation of the renal registry in 2004 and in the ensuing 4.5 years, the nation added 21,399 patients to the database. Of those new patients added, 58.2% had CKD-III; stages IV/V accounted for 24.8% of cases in the registry.
The nation also has a glomerulopathy registry, established in 1970! That registry reveals a national incidence of 58 cases per million population (pmp). Since 2000, physicians are mandated to register each GN patient since 2000. This registry has allowed frequent analyses, such as that which revealed an increase in IgA nephropathy (from 3.08 pmp/year in 1990 to 12.5 pmp/year in 2014). Additional analyses have shown a rise in both membranous nephropathy and lupus nephritis. Last but not least, analysis of the registry revealed that tubulointerstitial nephritis was mostly seen in female patients and often attributed to the use of medications.
The article then goes on a tour de force describing every aspect of the nephrology specialty in the country, from the delivery of dialysis, passing through prevention and critical, including pediatric nephrology, and ending with a perspective of the future of the specialty. At this point it is clear that Uruguayan physicians have a strong respect for the epidemiological methods to inform their decisions. The development of the specialty is relatively new and the past two decades have been showing them the direction they need to follow.
These registries also reveal the many challenges that exist and persist. Still, the Uruguayan team has a lot of heart and soul as they continue leveraging their registry data to understand how best to tackle kidney disease. Their future is bright in tackling kidney disease and fielding winning teams for the NephroWorldCup and FIFA World Cup.