Perfil epidemiológico dos pacientes em terapia renal substitutiva no Brasil, 2000-2004

Abstract

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.

Prevalence of latent tuberculosis and treatment adherence among patients with chronic kidney disease in Campo Grande, State of Mato Grosso do Sul

“…In the case of the latter, when assessed separately in this study, none of the patients had a positive TST result. The prevalence of these diseases was also detailed in the studies performed in Brazil by Cherchiglia et al 8 and Sesso et al 42 .…”

“…The morbidity and mortality rates of TB are high, particularly in patients of reproductive age, which results in increased treatment costs for CKD patients and renders TB a serious public health problem [6][7][8] .…”

Utilização de eritropoetina por pacientes incidentes em hemodiálise no Sistema Único de Saúde, Brasil, 2002-2003

“…No que se refere ao perfil da coorte geral e ao perfil dos pacientes segundo o uso de eritropoetina, o predomínio do sexo masculino é condizente com os achados de Acurcio et al 17 , Cherchiglia et al 18 e de Sesso et al 3 , que relataram predomínio dos homens entre os pacientes em tratamento de doença renal crônica no Brasil. Achados de Locatelli et al 10 também registraram predomínio de homens em tratamento dialítico nos países europeus, com proporções maiores de homens entre os pacientes incidentes, comparados aos prevalentes.…”

“…A hemodiálise é a modalidade predominante na terapia renal substitutiva no Brasil 3,6,18 e, também, a que apresenta percentual mais elevado de pacientes em uso de eritropoetina, em virtude da maior severidade da anemia nestes pacientes 11,19 .…”

Coping e qualidade de vida em pacientes em lista de espera para transplante renal

“…Treatment options are: hemodialysis, peritoneal dialysis, and transplantation. (2) According to the 2014 census of the Brazilian Society of Nephrology, there were an estimated 112,004 patients on dialysis treatment. Of the prevalent patients, 91% were on hemodialysis and 9% on peritoneal dialysis.…”