Doenças de base e desfechos em pacientes em terapia renal substitutiva via hemodiálise

Abstract

Introduction: The underlying diseases for the development of Chronic Kidney Disease (CKD) vary worldwide, however systemic arterial hypertension (SAH) and diabetes mellitus (DM) are the main causes, followed by primary glomerular diseases, polycystic kidneys and pyelonephritis. Therefore, the aim of this study was to describe primary causes and the correlation with the clinical outcomes of chronic renal failure patients on hemodialysis (HD). Methodology: This is a retrospective cohort study, carried out in five Renal Replacement Therapy (RRT) centers in the north of Rio Grande do Sul (RS), with the studied population including all patients who undergone HD between 2017- 2019. Results: The sample consisted of 702 patients, the majority of whom were male (63.8%), elderly (59.7%), white (90.8%), residents of the urban area (82%) and non smokers (73.7%). Regarding comorbities, SAH was the most commom, followed by DM. More than half used 5-9 medications everyday. The main outcomes were the maintenance of dialysis therapy (53.8%), followed by death (29.6%). There was a higher mortality in the elderly (p<0,001), in ischemic heart disease (p<0,001), in those with catheter as a vascular access (p<0,001), with URR <65% and Kt/V <1.2 (p<0,001), in those with more than 5 comorbidities (p <0.001) in individuals with smoking habit (p = 0.002), in DM (p = 0.002) and individuals in the polypharmacy (p = 0.001). Conclusions: The high cost of dialysis treatment 49 brings up the reflection and reiterates that patient care should start at Primary Care, in order to mitigate risk factors that lead to ESRD.