Insuficiência renal crônica no Brasil segundo enfoque de causas múltiplas de morte

Abstract

Cad. Saúde Colet., 2014, Rio de Janeiro, 22 (1): 75-85 75 Artigo OriginalResumo Este estudo investiga a mortalidade por doença renal crônica (DRC) por meio das causas múltiplas de morte no Brasil e apresenta a análise de associação entre as causas de óbitos de pacientes em terapia renal substitutiva (TRS), considerando causas associadas de morbimortalidade e características epidemiológicas e sociodemográficas. Utilizou-se a base nacional em TRS centrada no indivíduo para os anos de 2000 a 2004 e a técnica multivariada Grade of Membership (GoM). Os resultados apontam quatro perfis: doenças transmissíveis, doenças glomerulares e do aparelho digestivo; lesões, envenenamentos e outras consequências de causas externas e reação anormal ou complicação tardia causadas por procedimentos cirúrgicos (hemodiálise); diabetes e doenças cardiovasculares; e perfil residual. Entre os resultados destaca-se que aproximadamente 48% dos óbitos decorreram, provavelmente, de complicações do tratamento (hemodiálise) e 39%, de diabetes, além de uma condição cardiovascular na declaração de óbito. Os achados deste estudo podem contribuir para um atendimento mais adequado dos pacientes com DRC e, principalmente, dos potenciais pacientes no sistema de saúde. A prevenção e o acompanhamento das doenças associadas, especialmente diabetes e hipertensão, têm papel importante na prevenção e progressão da DRC, que é uma doença complexa e exige múltiplas abordagens de tratamento.Palavras-chave: mortalidade; causa de morte; causa básica de morte, insuficiência renal crônica. AbstractThis study investigates mortality from chronic kidney disease (CKD) by means of multiple causes of death in Brazil and also analyzes the association between causes of deaths of patients on renal replacement therapy (RRT), including associated causes on morbidity and mortality, epidemiological and sociodemographic characteristics. We used the National based on TRS centered on the individual, for the years 2000 to 2004, and the multivariate technique Grade of Membership (GoM). The results indicated four profiles: Communicable diseases, glomerular diseases and digestive tract; Injury, poisoning and other consequences of external causes and abnormal reaction or later complication caused by surgical procedures (hemodialysis); Diabetes and cardiovascular disease; Residual profile. Among the findings approximately 48% of deaths were due probably to complications of treatment (hemodialysis), and 39% due to diabetes and a heart condition. The findings of this study may contribute to a more suitable care to patients with CKD. Prevention and monitoring of diseases, especially diabetes and hypertension, have an important role in prevention and in avoiding progression of CKD, which is a complex disease and requires multiple treatment approaches.

Internações, óbitos e custos hospitalares pelas intercorrências dialíticas

“…This particularity is related to the deprivation of food resources, inaccessibility to water networks and above all, difficulties in access to public health services. 24 This is corroborated by a study 25 conducted through the National Database on Renal Replacement Therapy, which revealed a lower proportion of users who started dialysis treatment in the Northeast region. In addition, the authors emphasize that in the Northeast there is a prevalence of deaths caused by dialysis, estimated at 39.2%, in relation to other regions of the country.…”

“…It is inferred, therefore, that these results may reflect the insufficiency of care activities, since most complications were preventable. 25 It is estimated that, worldwide, adverse events in hospital institutions have high rates of magnitude. It is reported that, in Brazil, these indices are in agreement with those found in international studies, however, when dealing with avoidable adverse events, Brazil occupies a prominent position in proportional terms.…”

“…It is reported that, in Brazil, these indices are in agreement with those found in international studies, however, when dealing with avoidable adverse events, Brazil occupies a prominent position in proportional terms. 25 In this sense, it is cautioned that low-income places, such as the Northeastern territory, have the biggest problems related to public policies based on interventions to improve social determinants. 26 Thus, dialectical intercurrences are facilitated by this scenario.…”

Chronic kidney disease and periodontal disease. Case report

“…the accumulation of nitrogenous products in the bloodstream, such as urea and creatinine that should have been filtered and excreted by the kidneys [1,2]. According to Siviero et al [3], this condition is due to the natural process of population aging and the increasing number of carriers of diabetes mellitus and arterial hypertension, which are the most commonly associated morbidities.…”

Tratamento hemodialítico e seus impactos financeiros no nordeste do brasil

“…In the Northeast region, there are 134 active and regulated dialysis centers, which correspond to 18% of dialysis units in the country. 18 A study 19 showed that the Northeast region presented a smaller proportion of patients who started treatment. Some factors that contribute to this reality include the low educational level and socioeconomic condition.…”