Background: In the area of nephrology, the practical application of relative survival methodologies can provide information regarding the impact of outcomes for patients with kidney failure on dialysis compared with what would be expected in the absence of this condition. Objective: Compare the net survival of hemodialysis (HD) and peritoneal dialysis (PD) patients in a cohort of incident patients on chronic dialysis in Colombia, according to the dialysis therapy modality. Design: Observational, analytic, historical cohort. Setting: Renal Therapy Services (RTS) clinic network across Colombia. Patients: Patients over 18 years old with chronic kidney disease, incidents in dialytic therapy, which reached day 90 of therapy. Recruitment took place from January 1, 2008, to December 31, 2013, with a follow-up until December 31, 2018. The final cohort for analysis corresponds to a total of 12 508 patients, of which 5330 patients (42.6%) began HD and 7178 patients (57.4%) began PD. Measurements: Demographic, socioeconomic, and clinical variables were measured. Methods: Analyses were conducted according to the treatment assigned (PD or HD) at the time of the inception of the cohort and another approach of analysis was done with a subsample of those patients who never changed the initial modality. To calculate expected survival, life tables were constructed for Colombia for the years 2006 to 2018. Net survival estimates were made using the Pohar Perme estimator. The comparison of the net survival curves was done using the method developed by Pavlič and Perme, the log-rank type. Results: Net survival at 5 years compared with the general population was estimated at 0.53 (95% confidence interval 0.52-0.54) in the dialysis cohort. In intention-to-treat analyses of 7178 patients on PD and 5330 patients on HD, by global and Pohar-Perme methods, survival (expressed as a ratio of survival in patients on dialysis to survival in an age-, sex- and geographic-matched general Colombian population) was higher in patients on HD than in those on PD. In year 1, net survival by Pavlov-Perme on PD was 0.79 (95% confidence intervals [CI] 0.78 - 0.80) and on HD 0.85 (95% CI 0.84 - 0.86); in year 5, 0.36 (95% CI 0.34 – 0.38) and 0.57 (95% CI 0.55 – 0.59) for PD and HD respectively. Limitation: There may be imbalances among the populations analyzed (HD vs PD), in which one or more variables other than the type of therapy may influence the survival of the patients. In Colombia there are marginal levels of underreporting of demographic data in some subpopulations that may affect life-tables construction. Conclusion: An important difference was observed in terms of survival between the dialysis population and the population of reference without dialysis. Statistically significant differences were found in net survival between HD and PD, net survival was higher in patients on HD than in those on PD.
Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic cause of chronic kidney disease (CKD) that requires dialysis. Knowing geographical clusters can be a critical point for early diagnosis, progression control and genetic counseling. The objective was to establish the prevalence, geographic location, and racial distribution of patients with ADPKD who underwent dialysis or kidney transplant in Colombia between 2015 and 2019. Methods: Cross-sectional study with data from the national registry of chronic kidney disease (NRCKD) managed by the High Cost Diseases Fund (Cuenta de Alto Costo [CAC] in Spanish) between July 1, 2015, and June 30, 2019. Colombian residents who reported with CKD with or without renal replacement therapy (RRT) due to polycystic kidney disease were included. Crude and adjusted prevalence rates were estimated by state and city. Results: The ADPKD period prevalence was 9.81 per 100,000 people, there were 4.35 cases of RRT per 100,000 people, mean age 52.58 years (±13.21) and 52.78% women. Seventy-six patients were Afro-Colombians, 6 indigenous and 1 gypsy. A total of 46.07% began scheduled dialysis. The highest adjusted prevalence rate was in Valle del Cauca (6.55 cases per 100,000 people), followed by Risaralda, La Guajira and Amazonas. Regarding cities, Cali had the highest prevalence rate (9.38 cases per 100,000 people), followed by Pasto, Medellin and Bucaramanga. Conclusions: ADPKD prevalence is lower compared to Europe and USA, some states with higher prevalence will be objective to genetic prevalence study.
Background Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic cause of chronic kidney disease (CKD) that requires dialysis. Knowing geographical clusters can be critical for early diagnosis, progression control, and genetic counseling. The objective was to establish the prevalence, geographic location, and ethnic groups of patients with ADPKD who underwent dialysis or kidney transplant in Colombia between 2015 and 2019. Methods We did a cross-sectional study with data from the National Registry of Chronic Kidney Disease (NRCKD) managed by the High-Cost Diseases Fund (Cuenta de Alto Costo [CAC] in Spanish) between July 1, 2015, and June 30, 2019. We included Colombian population with CKD with or without renal replacement therapy (RRT) due to ADPKD. Crude and adjusted prevalence rates were estimated by state and city. Results 3,339 patients with ADPKD were included, period prevalence was 9.81 per 100,000 population; there were 4.35 cases of RRT per 100,000 population, mean age of 52.58 years (± 13.21), and 52.78% women. Seventy-six patients were Afro-Colombians, six were indigenous, and one Roma people. A total of 46.07% began scheduled dialysis. The highest adjusted prevalence rate was in Valle del Cauca (6.55 cases per 100,000 population), followed by Risaralda, and La Guajira. Regarding cities, Cali had the highest prevalence rate (9.38 cases per 100,000 population), followed by Pasto, Medellin, and Bucaramanga. Conclusions ADPKD prevalence is lower compared to Europe and US; some states with higher prevalence could be objective to genetic prevalence study.
Background: Estimating morbidity outcomes and the rate of progression of chronic kidney disease (CKD) patients is of great importance for the health systems. Objective: The objective of this study is to estimate the incidence of dialysis initiation and the rate of CKD progression in 2 years follow-up and identify factors associated with dialysis starts. Methods: A retrospective cohort study of adult with diagnosed CKD stages-G3, G4 (estimated glomerular filtration rate between 60 and 15 ml/min/1.73 m 2 ) enrolled into a CKD prevention program in
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