Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004.
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.
Cherchiglia
Mariangela Leal
ML
Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil. cherchml@medicina.ufmg.br
Machado
Elaine Leandro
EL
Szuster
Daniele Araújo Campo
DA
Andrade
Eli Iola Gurgel
EI
Assis Acúrcio
Francisco de
Fd
Caiaffa
Waleska Teixeira
WT
Sesso
Ricardo
R
Guerra Junior
Augusto A
AA
Queiroz
Odilon Vanni de
OV
Gomes
Isabel Cristina
IC
D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000401:mortality* / Q000706:statistics & numerical data