<?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>0016-3813</journal-id>
<journal-title><![CDATA[Gaceta médica de México]]></journal-title>
<abbrev-journal-title><![CDATA[Gac. Méd. Méx]]></abbrev-journal-title>
<issn>0016-3813</issn>
<publisher>
<publisher-name><![CDATA[Academia Nacional de Medicina de México A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0016-38132022001100013</article-id>
<article-id pub-id-type="doi">10.24875/gmm.m22000687</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Desorientación intrínseca y extrínseca en la atención nefrológica]]></article-title>
<article-title xml:lang="en"><![CDATA[Intrinsic and extrinsic disorientation in nephrological care]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Treviño-Becerra]]></surname>
<given-names><![CDATA[Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2022</year>
</pub-date>
<volume>158</volume>
<fpage>13</fpage>
<lpage>16</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0016-38132022001100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0016-38132022001100013&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0016-38132022001100013&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen En este ensayo se muestra que el desarrollo de la nefrología en los últimos lustros ha sido básicamente en la diálisis y el trasplante renal, pero es insuficiente y limitado el acceso a toda la población que los requieren, lo cual es un fenómeno universal. Además, se ha generado la fragmentación de la especialidad en otras subespecialidades. Entre otros motivos que impiden que los tomadores de decisiones se decidan por ampliar la atención nefrológica terciaria a mayor población se identifican 12 factores intrínsecos y cuatro extrínsecos, aunado a limitados recursos destinados a la investigación, por lo que se invita a que las sociedades nacionales de nefrología actúen y traten de modificar esos factores que son obstáculos para el desarrollo de la especialidad y la ampliación de la atención nefrológica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract This essay shows that the development of nephrology in recent years has been basically in dialysis and kidney transplantation, but access to the entire population that requires it is insufficient and limited, which is a universal phenomenon. In addition, the fragmentation of the specialty into other subspecialities has been generated. Among other reasons that prevent decision makers from deciding to expand tertiary nephrology care to a larger population, 12 intrinsic factors and four extrinsic factors are identified, together with limited resources dedicated to research; therefore, national societies of nephrology are encouraged to act and try to modify those factors that are obstacles to the development of the specialty and the expansion of nephrological care.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Atención nefrológica]]></kwd>
<kwd lng="es"><![CDATA[Protección renal]]></kwd>
<kwd lng="es"><![CDATA[Factores extrínsecos e intrínsecos]]></kwd>
<kwd lng="en"><![CDATA[Nephrology care]]></kwd>
<kwd lng="en"><![CDATA[Renal proteccion]]></kwd>
<kwd lng="en"><![CDATA[Intrinsic and extrinsic factors]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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