Acceptance for chronic dialysis treatment: insufficient and unequal

Abstract

Our results suggest that many ESRD patients die without receiving dialysis. Age and cause of renal disease influence the chance of being accepted for treatment. Restrictions of treatment need to be corrected to guarantee that maintenance dialysis will be accessible to ESRD patients.

Risk Factors for Hospital Death of Patients with End-Stage Renal Disease Without Previous Diagnosis of Severe Chronic Renal Failure Arriving in an Emergency Situation at the Hospital

“…The chance of ESRD individuals older than 60 years of age not reaching maintenance dialysis is 12.4 times higher than individuals from 20 to 29 years of age. [11] Our data showed an increase of 30% in the risk for death per 10 years of age increment.…”

“…Reinforcing this possibility, a data analysis of death certificate by Sesso et al found that 26% of end stage renal disease individuals died without receiving maintenance dialysis. [11] To our knowledge, the important issue of risk factors for death in nonreferred ESRD patients has not been specifically assessed. In the present study risk factors for death were increasing age, first nephrologic visit occurring in the ICU, presence of infection and need for more than three dialyses.…”

Anemia and End‐Stage Renal Disease in the Developing World

“…End‐stage renal disease (ESRD) is common in the developing countries, but providing renal replacement therapy (RRT) to uremic patients raises a serious medical problem with ethical and social aspects in view of limited financial resources (1–8). Thus, in many of these countries, access to RRT, if available, is rather restricted to a low proportion of patients reaching the end stage of their renal disease (2,7,9). The majority of these privileged patients have to start RRT in poor conditions related to the late referral and the patient load in dialysis centers (1).…”

Global Dialysis Perspective: Brazil

“…Although there is universal chronic dialysis coverage in Brazil, access to care is not uniform. Some patients with renal failure, particularly the oldest ones (7), those of lower social class, or those living far from health care centers with dialysis facilities (particularly in the north and northeast regions of the country), may not receive timely treatment. There is still considerable room for improvement regarding the integration of primary care facilities with more advanced health care centers.…”