The study identified higher use of medicines by women, making them more vulnerable to the harmful effects of polytherapy, such as drug interactions and inadequate use of medicines.

OBJECTIVE:To describe the clinical and epidemiological profi le of patients under renal replacement therapies, identifying risk factors for death. METHODS:This is a non-concurrent cohort study of data for 90,356 patients in the National Renal Replacement Therapies Database. A deterministicprobabilistic linkage was performed using the Authorization System for High Complexity/Cost Procedures and the Mortality Information System databases. All patients who started dialysis between 1/1/2000 and 12/31/2004 were included and followed until death or the end of 2004. Age, sex, region of residence, primary renal disease and causes of death were analyzed. A proportional hazards model was used to identify factors associated with risk of death. RESULTS:The prevalence of patients under renal replacement therapies increased an average of 5.5%, while incidence remained stable during the period. Hemodialysis was the predominant initial modality (89%). The patients were majority male with mean age 53 years, residents of the Southeast region and presented unknown causes as the main cause of chronic renal disease, followed by hypertension, diabetes and glomerulonephritis. Of these patients, 42% progressed to death and 7% underwent kidney transplantation. The patients on peritoneal dialysis were older and had higher prevalence of diabetes. The death rate varied from 7% among transplanted patients to 45% among non-transplanted patients. In the fi nal Cox proportional hazards model, the risk of mortality was associated with increasing age, female sex, having diabetes, living in the North and Northeast region, peritoneal dialysis as a fi rst modality and not having renal transplantation. CONCLUSIONS:There was an increased prevalence of patients on renal therapy in Brazil. Increased risk of death was associated with advanced age, diabetes, the female sex, residents of the North and Northeast region and lack of renal transplant.

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IntroduçãoOs sistemas de informação em saúde são ferramentas fundamentais para subsidiar a tomada de decisões e auxiliar a organização dos serviços, por meio do planejamento das ações e do acompanhamento e avaliação dos objetivos propostos. O sistema de saúde brasileiro tem larga experiência com a captura e o uso de informações. No entanto, Morais e Gómez (2007) fazem uma reflexão de que os atuais pressupostos, práticas e saberes de informação e informática em saúde não mais dão conta da complexidade do processo saúde/doença/cuidado, apontando algumas questões: a fragmentação dos indivíduos entre diversas bases de dados em saúde, o que acar-

The availability of essential drugs in public facilities is low and varies widely, with the result that persons who need such drugs the most are often those who lack access to them. Private pharmacies are the main source of essential drugs. The results of this study point to the need to seek increased awareness and implementation of the concept of essential drugs throughout the country.