Diálise planejada e a utilização regular da atenção primária à saúde entre os pacientes diabéticos do Município de Belo Horizonte, Minas Gerais, Brasil

Abstract

The objective was to analyze factors associated with planned initiation of dialysis in diabetic patients in the city of Belo Horizonte, Minas Gerais State, Brazil. This was a cross-sectional study of 250 diabetic patients who began dialysis between January 2006 and December 2007. Initiating dialysis with an arteriovenous fistula or in peritoneal dialysis was classified as planned initiation. The study targeted socio-demographic, clinical, and health services use variables using a semi-structured interview. Multivariate analysis used Poisson regression. Seventy per cent of the patients began dialysis on an unplanned basis, and 67% of those consulted had been referred to a nephrologist more than four months previously. Attending a health center, not having the first nephrology appointment paid for by the Brazilian Unified National Health System, and having a choice of treatment for the kidney disease were associated with planned initiation of dialysis. Unplanned initiation of dialysis is common in the city of Belo Horizonte and occurs regardless of the time since referral to the nephrologist.

Tradução, adaptação transcultural e validação do questionário EPOCH-RRT “Empowering Patients On Choices For Renal Replacement Therapy” para o contexto brasileiro

“…No Brasil, a maioria dos indivíduos inicia TRS em urgência ou emergência dialítica, sem acesso planejado e sem informação. O estudo de Peixoto et al, em Belo Horizonte, mostrou que 70% dos pacientes iniciaram diálise de forma não planejada 9 .…”

Translation, cross-cultural adaptation and validation of the EPOCH-RRT questionnaire “Empowering Patients On Choices For Renal Replacement Therapy” for the Brazilian context

“…In Brazil, most individuals initiate RRT under urgent or emergency dialysis basis, without planned access and without information. The study by Peixoto et al, in Belo Horizonte, showed that 70% of patients started dialysis in an unplanned way 9 .…”

Hemodialysis services: are public policies turned to guaranteeing the access?

“…Chronic renal failure (CRF) is the final stage of CKD, which leads to the necessity of hemodialysis 1 . A study of the Organisation for Economic Co-operation and Development (OECD) indicated an increased prevalence of around 5% per year in member countries by analyzing data from 1990 to 2009 2 .…”

“…In 2000s, there was an increase in dialysis clinics from 550 in 2002 to 651 in 2012 3 . Increase in the number of patients and demand for such clinical intervention was crucial in the formulation of the National Policy of Attention to Renal Patients in 2004 1 . CKD increasingly presents an important public health issue, with a strong push toward public policies for health prevention, promotion, and recovery 10,11,12,13 .…”