Mortality in patients with chronic kidney disease undergoing hemodialysis in a public hospital of Peru

Herrera-Añazco, Percy; Benítes-Zapata, Vicente A.; Hernandez, Adrián V.; Mezones‐Holguín, Edward; Silveira-Chau, Manuela

doi:10.5935/0101-2800.20150031

Cited by 20 publications

(23 citation statements)

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“…This is higher than mortality rates attributable to chronic glomerulonephritis of 10% observed in our study. Contrary to our findings, a study conducted in Peru on mortality rates in patients with CKD undergoing haemodialysis reported 51.9% mortality due to diabetic nephropathy, 24.1% due to chronic glomerulonephritis and 13.0% due to hypertensive nephropathy . This underscores the varying patterns of attributable cause of death among renal patients globally.…”

Section: Discussioncontrasting

confidence: 99%

20 year trends in renal disease mortality in Ghana: A review of autopsies

et al. 2019

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We observed marked increase in renal disease mortality rate during the last few years predominantly driven by chronic and infectious related renal diseases as main cause, and hypertensive heart disease and congestive heart failure as main secondary causes. Measures geared towards prevention, treatment and managing such conditions may impact on the reduction of renal disease mortality rate among Ghanaian populations.

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Section: Discussioncontrasting

confidence: 99%

20 year trends in renal disease mortality in Ghana: A review of autopsies

et al. 2019

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“…Appropriate medical intervention in these early stages decreases the risk of progression to late stages where the patient is likely to require some form of renal replacement therapy such hemodialysis (HD) [16]. This provides an opportunity to our health system, where CKD screening in at-risk population is deficient [26] and to our Ministry of Health since this institution has national HD coverage problems and has reported high mortality HD incident population, associated with late CKD detection in the Peruvian population [15, 27]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence of chronic kidney disease in Peruvian primary care setting

et al. 2017

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BackgroundChronic Kidney Disease (CKD) is a worldwide public health problem. There are few studies in Latin America, especially in primary care settings. Our objective was to determine the prevalence, stages, and associated factors of CKD in primary care setting.MethodsWe did a retrospective secondary analysis of a database from the Diabetes and Hypertension Primary Care Center of the Peruvian Social Security System (EsSalud) in Lima, Peru. We defined CKD as the presence of eGFR <60 mL/min and/or albuminuria >30 mg/day in 24 h, according to Kidney Disease: Improving Global Outcomes (KDIGO). Factors associated with CKD were evaluated with Poisson Regression models; these factors included age, gender, type 2 diabetes mellitus (DM2), hypertension (HTN), body mass index (BMI), and uric acid. Associations were described as crude and adjusted prevalence ratios (PR) and their 95% confidence intervals (95% CI).ResultsWe evaluated 1211 patients (women [59%], mean age 65.8 years [SD: 12.7]). Prevalence of CKD was 18%. Using the estimated glomerular filtration rate (eGFR), the prevalence was 9.3% (95% CI 5.3 – 13.3) in patients without HTN or DM2; 20.2% (95% CI 17.6 – 22.8) in patients with HTN, and 23.9% (95% CI 19.4 – 28.4) in patients with DM2. The most common stages were 1 and 2 with 41.5% and 48%, respectively. Factors associated with CKD in the adjusted analysis were: age in years (PR = 1.03, 95% CI 1.01 – 1.04), DM2 (PR = 3.37, 95% CI 1.09 – 10.39), HTN plus DM2 (PR = 3.90, 95% CI 1.54 – 9.88), and uric acid from 5 to <7 mg/dL (PR = 2.04, 95% CI 1.31 – 3.19) and ≥7 mg/dL (PR = 5.19, 95% CI 3.32 – 8.11).ConclusionsPrevalence of CKD in the primary care setting population was high. CKD is more frequent in the early stages of the disease, and individuals with hypertension, DM2, older age and hyperuricemia have higher prevalence of CKD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-017-0655-x) contains supplementary material, which is available to authorized users.

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“…Two works of recent publication warned of the work overload, stress, and the social demand not covered in the public hospitals of Peru (Herrera-Añazco et al 2015b), and the consequences that such a situation has on the training of physicians-in-training and medical students in the case of teaching hospitals, (Herrera-Añazco et al 2015b). In both jobs, some of the hospitals where the students in this study underwent their clinical rotations, were included.…”

Section: Jsapnc Jefferson Scale Of Attitudes Toward Physician-nurse Cmentioning

confidence: 99%

“…Recent studies have warned about the challenges and difficulties that this model poses to health care institutions, which are forced to know how to combine professional responsibility toward the patient, with the responsibility of teaching the student (Duvivier et al 2014). In countries such as Peru, where public hospitals have insufficient resources to respond to the social demands (Herrera-Añazco et al 2015a), teachers are confronted with important difficulties and challenges to adequately respond to the training needs of the students and the doctors in training (Herrera-Añazco et al 2015b).…”

Section: Introductionmentioning

confidence: 99%

Moral perception, educational environment, and development of medical professionalism in medical students during the clinical rotations in Peru

San-Martín

Rivera

Alcorta-Garza³

et al. 2016

International Journal of Ethics Education

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The aim of this study was to determine the relationship between a clinical environment and the development of empathy, teamwork, and lifelong learning in medical students who are doing their first clinical rotation. The Jefferson Scales of Empathy (JSE), Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC), and Jefferson Scale of Physician Lifelong Learning (JeffSPLLL) were administered to 60 sixth-year medical students, before and after their first clinical rotation in five health care institutions. The Dundee Ready Education Environment Measure questionnaire (DREEM) was administered to measure their perception of the educational environment after the rotation was finished. Scores were compared to determine differences before and after the rotation. Other variables associated with gender, age, and moral perception, were included into the comparisons. A correlation analysis was also performed. The analyses confirmed a positive association among the measured elements of medical professionalism. Lifelong learning decreased (p = 0.03) after the rotation. Associations were found between the educational environment and the development of lifelong learning (P = +0.29; p = 0.03); and between the International Journal of Ethics Education (2016) Area of Health, Nutrition and Bioethics, Iberoamerican University Foundation (FUNIBER), Barcelona, Spain development of attitudes toward teamwork and the educational environment (P = + 0.29; p = 0.03). During the rotational internship, the development of some components of professionalism in medical students is influenced by the clinical environment. Gender, age, and moral perception influence the development of some elements of medical professionalism and the perception of the educational environment.

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Mortality in patients with chronic kidney disease undergoing hemodialysis in a public hospital of Peru

Abstract: Half of patients died within seven months of follow-up. Scheduled dialysis and having longer time with CKD diagnosis tend to be associated with lower mortality.

Cited by 20 publications

References 14 publications

20 year trends in renal disease mortality in Ghana: A review of autopsies

20 year trends in renal disease mortality in Ghana: A review of autopsies

Prevalence of chronic kidney disease in Peruvian primary care setting

Moral perception, educational environment, and development of medical professionalism in medical students during the clinical rotations in Peru

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