Diferenças e desigualdades no acesso a terapia renal substitutiva nos países do BRICS

Abstract

End-stage renal disease (ESRD) is an important public health problem, especially in developing countries due to the high level of economic resources needed to maintain patients in the different programs that make up renal replacement therapy (RRT). To analyze the differences and inequalities involved in access to RRT in the BRICS countries (Brazil, Russian Federation, India, China and South Africa). This is an applied, descriptive, cross-sectional, quantitative and qualitative study, with documentary analysis and a literature review. The sources of data were from national censuses and scientific publications regarding access to RRT in the BRICS countries. There is unequal access to RRT in all the BRICS countries, as well as the absence of information regarding dialysis and transplants (India), the absence of effective legislation to inhibit the trafficking of organs (India and South Africa) and the use of deceased prisoners as donors for renal transplants (China). The construction of mechanisms to promote the sharing of benefits and solidarity in the field of international cooperation in the area of renal health involves the recognition of bioethical issues related to access to RRT in the BRICS countries.

Caracterização das pessoas com tratamento de hemodiálise na região sul do Rio Grande do Sul, Brasil

“…Por otro lado, la inestabilidad del sistema de salud trae consigo problemas económicos posteriores al tratamiento de reemplazo renal y los ingresos hospitalarios, aunado a la vulnerabilidad socioeconómica asociada a cada servicio, lo cual puede implicar una restricción en el tratamiento 14,17 .…”

“…Incluso los niveles más altos de educación están relacionados con mejores ingresos, posesión de bienes y acceso a servicios. Además, saber leer facilita la percepción de autocuidado, prevención, control y recuperación de las condiciones de salud y enfermedad 1,[15][16][17][18][19] . Se observa que las poblaciones minoritarias tienen más probabilidades de tener multimorbilidad y vivir en áreas de vulnerabilidad socioeconómica [18][19][20][21][22][23][24] .…”

Transplantes de órgãos sólidos no Brasil: estudo descritivo sobre desigualdades na distribuição e acesso no território brasileiro, 2001-2017*

“…A possible explanation for this finding may lie in the fact of the most common underlying diseases in modern society, such as arterial hypertension and diabetes, tending to unleash kidney problems, leading to greater probabilities of kidney failure and, consequently, greater need for kidney transplants. [25][26] According to Ribeiro & Schramm, 27 working to prevent disease and promote health is an important strategy for minimizing cases needing transplants. It is also noteworthy that deceased kidney donors can benefit up to two candidates, apart from the possibility of donation by someone who is alive, which also contributes to there being a high number of kidney transplants.…”

Autoavaliação da saúde de indivíduos com doença renal crônica em terapia dialítica [Health self-assessment by individuals with chronic kidney disease in dialysis therapy] [Autoevaluación de la salud de individuos con enfermedad renal crónica en terapia dialítica]

“…A DRC assumiu importância global em virtude do exponencial aumento dos casos registrados. O Brasil está em primeiro lugar na prevalência de pacientes em TRS e na proporção de investimentos do Produto Interno Bruto (PIB) em saúde 6 .…”