Aversa Santos Guilherme Palhares, Sesso Ricardo, Lugon Jocemir Ronaldo, Miranda de Menezes Neves Precil Diego, Pacheco Barbosa Abner Mácola, Camila da Rocha Naila, Modelli de Andrade Luis Gustavo
Department of Internal Medicine-UNESP, Univ Estadual Paulista, Botucatu, Brazil.
Division of Nephrology, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
Kidney360. 2024 Oct 1;5(10):1477-1489. doi: 10.34067/KID.0000000000000539. Epub 2024 Aug 6.
A large comprehensive analysis of patients undergoing KRT within Brazil's Public Health System from 2015 to 2023. We reported an increase in the age at which dialysis began and a decline in the adoption of peritoneal dialysis over the years. We showed better hemodialysis adequacy as measured by single-pool Kt/V.
Brazil has the largest public health system providing universal coverage for chronic dialysis. The objective was to describe the number, sociodemographic, and clinical characteristics of patients undergoing KRT by dialysis within the public health system in Brazil.
We carried out a retrospective cohort study analyzing the database from the Brazilian Public Health System, focusing on procedures related to KRT. The study encompassed both prevalent and incident patients who underwent KRT in Brazil between 2015 and 2023.
We observed an increase in the number and prevalence rate of dialysis patients from 2015 to 2023. We also noticed an increase in the age at dialysis initiation and in the prevalence of mixed-race patients and a reduction in the proportion of those undergoing peritoneal dialysis and with arteriovenous fistula. We identified an upward trajectory in the values of single-pool Kt/V over the years, contrasting with a decline in hemoglobin levels. The overall estimated prevalence rate of dialysis patients increased from 654 per million population (pmp) to 792 pmp over the years. The survival rates of incident patients undergoing KRT at 12 and 96 months were 81% and 60%, respectively.
We reported an increase in the age at which dialysis began and a decline in the adoption of peritoneal dialysis over the years. Although there have been some improvements over the years resulting in better adequacy of hemodialysis as measured by Kt/V, controlling certain parameters, such as hemoglobin levels, has remained challenging.
对2015年至2023年在巴西公共卫生系统接受肾脏替代治疗（KRT）的患者进行了大规模综合分析。我们报告了透析开始年龄的增加以及多年来腹膜透析采用率的下降。我们发现，通过单池Kt/V衡量，血液透析充分性有所改善。
巴西拥有最大的公共卫生系统，为慢性透析提供全民覆盖。目的是描述在巴西公共卫生系统中通过透析接受KRT的患者数量、社会人口统计学和临床特征。
我们进行了一项回顾性队列研究，分析巴西公共卫生系统的数据库，重点关注与KRT相关的程序。该研究涵盖了2015年至2023年在巴西接受KRT的现患和新发病患者。
我们观察到2015年至2023年透析患者数量和患病率有所增加。我们还注意到透析开始年龄以及混血患者患病率增加，而接受腹膜透析和动静脉内瘘患者的比例有所下降。我们发现多年来单池Kt/V值呈上升趋势，与之形成对比的是血红蛋白水平下降。透析患者的总体估计患病率多年来从每百万人口654例增加到792例。接受KRT的新发病患者在12个月和96个月时的生存率分别为81%和60%。
我们报告了透析开始年龄的增加以及多年来腹膜透析采用率的下降。尽管多年来有一些改善，导致通过Kt/V衡量的血液透析充分性更好，但控制某些参数，如血红蛋白水平，仍然具有挑战性。
