Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/32814 |
Resumo: | OBJECTIVE: To describe the clinical and epidemiological profile 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 deterministic-probabilistic 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 final 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 first 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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Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 Perfil epidemiológico de los pacientes en terapia renal substitutiva en Brasil, 2000-2004 Perfil epidemiológico dos pacientes em terapia renal substitutiva no Brasil, 2000-2004 Insuficiência Renal Crônica^i1^sepidemioloTerapia de Substituição RenalSistemas de Informação HospitalarRegistros de MortalidadeInsuficiencia Renal Crónica^i3^sepidemioloTerapia de Reemplazo RenalSistemas de Información en HospitalRegistros de MortalidadRenal InsufficiencyChronic^i2^sepidemiolRenal Replacement TherapyHospital Information SystemsMortality Registries OBJECTIVE: To describe the clinical and epidemiological profile 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 deterministic-probabilistic 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 final 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 first 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. OBJETIVO: Describir el perfil epidemiológico y clínico de pacientes en terapia renal substitutiva, identificando factores asociados al riesgo de muerte. MÉTODOS: Estudio de observación, prospectivo no concurrente, a partir de datos de 90.356 pacientes de la Base Nacional en Terapias Renales Substitutivas, en Brasil. Fue realizado reracionamiento determinístico-probabilístico del Sistema de Información de Mortalidad. Fueron incluidos todos los pacientes incidentes que iniciaron diálisis entre 1/1/2000 y 31/12/2004, acompañados hasta la muerte o final de 2004. Edad, sexo, región de residencia, enfermedad renal primaria, causa del óbito fueron analizados. Se ajustó un modelo de riesgos proporcionales para identificar factores asociados al riesgo de muerte. RESULTADOS: Ocurrió un aumento promedio de 5,5% en la prevalencia de pacientes en terapia, con relación a la incidencia se mantuvo estable en el período. Hemodiálisis fue la modalidad inicial predominante (89%). La mayoría de los pacientes era del sexo masculino, con edad promedio de 53 años, residente en la región Sureste y presentaba causa indeterminada como principal causa básica de la enfermedad renal crónica, seguida de la hipertensión, diabetes y glomerulonefritis. De esos pacientes, 7% realizaron transplante renal y 42% evolucionaron a óbito. Los pacientes en diálisis peritoneal eran más ancianos y presentaban mayor prevalencia de diabetes. Entre los no transplantados, 45% fueron a óbito y, entre los transplantadas 7%. En el modelo final de riesgos proporcionales de Cox, el riesgo de mortalidad estuvo asociado con el aumento de la edad, sexo femenino, tener diabetes, residir en la región Norte y Noreste, diálisis peritoneal como modalidad de entrada y no haber realizado transplante renal. CONCLUSIONES: Hubo aumento de la prevalencia de pacientes en terapia renal en Brasil. Pacientes con edad avanzada, diabetes, del sexo femenino, residentes en la región Norte y Noreste y sin transplante renal presentan mayor riesgo de muerte. OBJETIVO: Descrever o perfil epidemiológico e clínico de pacientes em terapia renal substitutiva, identificando fatores associados ao risco de morte. MÉTODOS: Estudo observacional, prospectivo não concorrente, a partir de dados de 90.356 pacientes da Base Nacional em Terapias Renais Substitutivas, no Brasil. Foi realizado relacionamento determinístico-probabilístico do Sistema de Autorização de Procedimentos de Alta Complexidade/Custo e do Sistema de Informação de Mortalidade. Foram incluídos todos os pacientes incidentes que iniciaram diálise entre 1/1/2000 e 31/12/2004, acompanhados até a morte ou final de 2004. Idade, sexo, região de residência, doença renal primária, causa do óbito foram analisados. Ajustou-se um modelo de riscos proporcionais para identificar fatores associados ao risco de morte. RESULTADOS: Ocorreu um aumento médio de 5,5% na prevalência de pacientes em terapia enquanto a incidência manteve-se estável no período. Hemodiálise foi a modalidade inicial predominante (89%). A maioria dos pacientes era do sexo masculino, com idade média de 53 anos, residente na região Sudeste, e apresentava causa indeterminada como principal causa básica da doença renal crônica, seguida da hipertensão, diabetes e glomerulonefrites. Desses pacientes, 7% realizou transplante renal e 42% evoluiu para o óbito. Os pacientes em diálise peritoneal eram mais idosos e apresentavam maior prevalência de diabetes. Entre os não transplantados, 45% foi a óbito e, entre os transplantados, 7%. No modelo final de riscos proporcionais de Cox, o risco de mortalidade foi associado com o aumento da idade, sexo feminino, ter diabetes, residir nas regiões Norte e Nordeste, diálise peritoneal como modalidade de entrada e não ter realizado transplante renal. CONCLUSÕES: Houve aumento da prevalência de pacientes em terapia renal no Brasil. Pacientes com idade avançada, diabetes, do sexo feminino, residentes nas regiões Norte e Nordeste e sem transplante renal apresentam maior risco de morte. Universidade de São Paulo. Faculdade de Saúde Pública2010-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3281410.1590/S0034-89102010000400007Revista de Saúde Pública; Vol. 44 No. 4 (2010); 639-649 Revista de Saúde Pública; Vol. 44 Núm. 4 (2010); 639-649 Revista de Saúde Pública; v. 44 n. 4 (2010); 639-649 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporenghttps://www.revistas.usp.br/rsp/article/view/32814/35334https://www.revistas.usp.br/rsp/article/view/32814/35335Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessCherchiglia, Mariangela LealMachado, Elaine LeandroSzuster, Daniele Araújo CampoAndrade, Eli Iola GurgelAcúrcio, Francisco de AssisCaiaffa, Waleska TeixeiraSesso, RicardoGuerra Junior, Augusto AQueiroz, Odilon Vanni deGomes, Isabel Cristina2012-07-10T02:23:36Zoai:revistas.usp.br:article/32814Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-10T02:23:36Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 Perfil epidemiológico de los pacientes en terapia renal substitutiva en Brasil, 2000-2004 Perfil epidemiológico dos pacientes em terapia renal substitutiva no Brasil, 2000-2004 |
title |
Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 |
spellingShingle |
Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 Cherchiglia, Mariangela Leal Insuficiência Renal Crônica^i1^sepidemiolo Terapia de Substituição Renal Sistemas de Informação Hospitalar Registros de Mortalidade Insuficiencia Renal Crónica^i3^sepidemiolo Terapia de Reemplazo Renal Sistemas de Información en Hospital Registros de Mortalidad Renal Insufficiency Chronic^i2^sepidemiol Renal Replacement Therapy Hospital Information Systems Mortality Registries |
title_short |
Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 |
title_full |
Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 |
title_fullStr |
Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 |
title_full_unstemmed |
Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 |
title_sort |
Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 |
author |
Cherchiglia, Mariangela Leal |
author_facet |
Cherchiglia, Mariangela Leal Machado, Elaine Leandro Szuster, Daniele Araújo Campo Andrade, Eli Iola Gurgel Acúrcio, Francisco de Assis Caiaffa, Waleska Teixeira Sesso, Ricardo Guerra Junior, Augusto A Queiroz, Odilon Vanni de Gomes, Isabel Cristina |
author_role |
author |
author2 |
Machado, Elaine Leandro Szuster, Daniele Araújo Campo Andrade, Eli Iola Gurgel Acúrcio, Francisco de Assis Caiaffa, Waleska Teixeira Sesso, Ricardo Guerra Junior, Augusto A Queiroz, Odilon Vanni de Gomes, Isabel Cristina |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Cherchiglia, Mariangela Leal Machado, Elaine Leandro Szuster, Daniele Araújo Campo Andrade, Eli Iola Gurgel Acúrcio, Francisco de Assis Caiaffa, Waleska Teixeira Sesso, Ricardo Guerra Junior, Augusto A Queiroz, Odilon Vanni de Gomes, Isabel Cristina |
dc.subject.por.fl_str_mv |
Insuficiência Renal Crônica^i1^sepidemiolo Terapia de Substituição Renal Sistemas de Informação Hospitalar Registros de Mortalidade Insuficiencia Renal Crónica^i3^sepidemiolo Terapia de Reemplazo Renal Sistemas de Información en Hospital Registros de Mortalidad Renal Insufficiency Chronic^i2^sepidemiol Renal Replacement Therapy Hospital Information Systems Mortality Registries |
topic |
Insuficiência Renal Crônica^i1^sepidemiolo Terapia de Substituição Renal Sistemas de Informação Hospitalar Registros de Mortalidade Insuficiencia Renal Crónica^i3^sepidemiolo Terapia de Reemplazo Renal Sistemas de Información en Hospital Registros de Mortalidad Renal Insufficiency Chronic^i2^sepidemiol Renal Replacement Therapy Hospital Information Systems Mortality Registries |
description |
OBJECTIVE: To describe the clinical and epidemiological profile 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 deterministic-probabilistic 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 final 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 first 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. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/32814 10.1590/S0034-89102010000400007 |
url |
https://www.revistas.usp.br/rsp/article/view/32814 |
identifier_str_mv |
10.1590/S0034-89102010000400007 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/32814/35334 https://www.revistas.usp.br/rsp/article/view/32814/35335 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 44 No. 4 (2010); 639-649 Revista de Saúde Pública; Vol. 44 Núm. 4 (2010); 639-649 Revista de Saúde Pública; v. 44 n. 4 (2010); 639-649 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221791025627136 |