Quality of life of patients in renal replacement therapy in Brazil: comparison of treatment modalities

Álvares, Juliana; César, Cibele Comini; Acúrcio, Francisco de Assis; Andrade, Eli Iôla Gurgel; Cherchiglia, Mariângela Leal

doi:10.1007/s11136-011-0013-6

Cited by 59 publications

(81 citation statements)

References 23 publications

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“…Most patients do not get kidney transplant though it has been shown to be the best modality for renal replacement therapy as compared to hemodialysis and peritoneal dialysis [5][6][7][8][9][10]. In Ghana, patients on hemodialysis have high mortality rate [24].…”

Section: Discussionmentioning

confidence: 99%

“…Chronic kidney disease inevitably progresses to end-stage renal disease (ESRD) which requires renal replacement therapy (RRT) in the form of hemodialysis, peritoneal dialysis, or renal transplantation as the main modalities of treatment. It has been shown consistently that renal transplantation is cost effective and improves patient survival and quality of life as compared to peritoneal dialysis and hemodialysis [5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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The geographical distribution of dialysis services in Ghana

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The geographical distribution of dialysis services in Ghana

et al. 2018

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“…Transplantation provides the patients with a better quality of life and full reintegration into daily activities in addition to increasing their life expectancy and representing the most cost effective option (Alvares et al 2011, Harada et al 2009). …”

Section: Introductionmentioning

confidence: 99%

Evaluation of the predisposition and clinical impact of BK virus replication in kidney transplant patients

Moura

Petzhold

Amaral

et al. 2017

An. Acad. Bras. Ciênc.

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The BK virus (BKV) produces a subclinical kidney infection in immunocompetent individuals. However, viremia may occur in kidney transplant patients with ongoing immunosuppression. BKV-associated nephropathy (BKVN) has no specific treatment and is a leading cause of organ transplant loss. In this study, we evaluated the predisposition and the clinical impact of BKV replication in kidney transplant patients during post-transplant monitoring in a reference institution in Brazil. Demographic, clinical and laboratory data generated during routine outpatient follow-up were retrospectively collected. BK viremia was investigated using real-time polymerase chain reaction. Of the 553 participants, 7.4% (n = 41) presented BKV replication. Of these, 16 (39%) lost their kidney graft and interstitial nephritis was identified on kidney biopsy in 50% of the cases. Among the evaluated variables, only the use of the immunosuppressant mycophenolate sodium was identified as a risk factor for viremia (OR 7.96; 95% CI 2.35 to 26.98). The graft survival estimate in BKV-positive patients was significantly reduced (24.8% vs. 85.6%) after 10 years of transplantation. We concluded that defining predisposing factors remains an important challenge for the prevention and control of BKV activity following kidney transplantation, especially considering the development of BKVN and its strong effect on graft maintenance.

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“…Entre essas vale destacar a insuficiência renal crônica, pela perda da qualidade de vida que provoca no paciente e por seu alto impacto econômico para o sistema de saú-de 1 . O tratamento atualmente disponível consiste em duas modalidades de diálise (diálise peritoneal e hemodiálise) e no transplante renal.…”

Section: Introductionunclassified

“…O tratamento atualmente disponível consiste em duas modalidades de diálise (diálise peritoneal e hemodiálise) e no transplante renal. A literatura tem demonstrado ser o transplante a alternativa mais custo-efetiva, uma vez que permite a reintegração do paciente às suas atividades cotidianas e melhora tanto a expectativa quanto a qualidade de vida 1,2 . Por sua vez, o sucesso do transplante tem sido influenciado pela evolução da terapia imunossupressora, que é essencial para a manutenção do órgão transplantado.…”

Section: Introductionunclassified

Análise de custo-efetividade dos imunossupressores utilizados no tratamento de manutenção do transplante renal em pacientes adultos no Brasil

et al. 2013

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O objetivo do estudo foi realizar análise custoefetividade de imunossupressores utilizados na terapia de manutenção pós-transplante renal. Coorte hipotética de adultos transplantados foi acompanhada por 20 anos, empregando-se modelo de Markov. Os 10 esquemas terapêuticos avaliados continham prednisona (P). O custo médio dos medicamentos foi obtido na Câmara de Regulação do Mercado de Medicamentos. Outros custos assistenciais compuseram cada estágio da doença. O custo foi expresso em reais, a efetividade em anos de vida ganhos e adotou-se a perspectiva do sistema público de saúde. Ao fim do acompanhamento, a análise com desconto mostrou que todos os esquemas foram dominados por ciclosporina(CSA)+azatioprina(AZA) +P. Nas demais análises, tacrolimo+AZA+P não foi dominado, mas a relação custo-efetividade incremental entre estes dois esquemas foi de R$ 156.732,07/ anos de vida ganhos, na análise sem desconto, valor que ultrapassa o limiar de três vezes o PIB per capita brasileiro. Nenhuma alteração qualitativa foi demonstrada pela análise de sensibilidade e a probabilidade do esquema CSA+AZA+P ser o mais custo-efetivo é superior a 85%.

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Quality of life of patients in renal replacement therapy in Brazil: comparison of treatment modalities

Abstract: Renal transplant patients have the best quality of life of the three treatment modalities. It is necessary to increase access to renal transplants.

Cited by 59 publications

References 23 publications

The geographical distribution of dialysis services in Ghana

The geographical distribution of dialysis services in Ghana

Evaluation of the predisposition and clinical impact of BK virus replication in kidney transplant patients

Análise de custo-efetividade dos imunossupressores utilizados no tratamento de manutenção do transplante renal em pacientes adultos no Brasil

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