Iniquities in the access to renal transplant for patients with end-stage chronic renal disease in Brazil

Abstract

The objective of this present study is to analyze individual and contextual factors associated with access to renal transplant in Brazil. An observational, prospective and non-concurrent study was carried out, based on data from the National Database on renal replacement therapies in Brazil. Patients undergoing dialysis between 01/Jan/2000 and 31/Dec/2000 were included and monitored up to the point of transplant, death or until the end of the study period. Variables that were analyzed included: individual variables (age, sex, region of residence, primary renal disease, hospitalizations); and context variables concerning both the dialysis unit (level of complexity, juridical nature, hemodialysis machines and location) and the city (geographic region, location and HDI). Proportional hazard models were adjusted with hierarchical entry to identify factors associated with the risk of transplant. The results point to differentials in access according to socio-demographic, clinical, geographic and social factors, indicating that the organ allocation system has not eliminated avoidable disparities for those who compete for an organ in the nationwide waiting list.

Translation, cultural adaptation and validation of Kidney Disease Loss Scale to the Brazilian context

“…The issues outlined in this study corroborate the findings in national and international literature regarding characteristics of individuals with CKD. [10][11][12][13][14][15] We should reiterate that CKD, in its terminal stage requires a process of losses and adjustments to the people who need this treatment. The loss is associated with coping, adherence to treatment and quality of life.…”

Is there an Association Between Comorbidities and Income or Literacy in Incident Dialysis Patients Living in Contagem, Brazil?

“…In our country the increasing number of patients with poor controlled diabetes mellitus, hypertension and obesity is critically contributing to transform end-stage renal disease in an epidemic of elevated costs [1,2,5,8,9]. Studies performed in several locations have suggested that morbidity and mortality due to non-communicable chronic diseases are greatest in disadvantaged populations once socioeconomic iniquities are suspected to be an important risk factor to trigger sustained unhealthy lifestyle habits [1,7,[10][11][12][13][14][15].…”

Cotidiano de pacientes renais crônicos submetidos à hemodialise: expectativas, modificações e relações sociais Chronic renal patients everyday on hemodialysis: expectations, modifications and social relations

“…The support of family can be beneficial, and as a coping strategy. Thus, social support can serve as support for the negative consequences for the decay of physical function in the process of becoming ill. 18 In the central idea "Prejudice and isolation", changes both in family life and social are observed. This is linked to the reflections caused by the disease itself, which in the course of their evolution brings many changes in lifestyle due to the source of stress.…”