Survival analysis of dialysis patients in the Brazilian Unified National Health System

The aim of this study was to analyze the survival of patients who initiated renal replacement therapy (RRT) with hemodialysis or peritoneal dialysis in the Brazilian Unified National Health System from 2002 to 2004. This was an observational, prospective, non-concurrent study. The study used the Nat...

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Bibliographic Details
Published in:Cadernos de saúde pública 2012-03, Vol.28 (3), p.415-424
Main Authors: Szuster, Daniele Araújo Campos, Caiaffa, Waleska Teixeira, Andrade, Eli Iola Gurgel, Acurcio, Francisco de Assis, Cherchiglia, Mariangela Leal
Format: Article
Language:Portuguese
Subjects:
Brazil
Brazil - epidemiology
Cities
Diabetes
Female
Females
Health Care Services
Human Development
Humans
Male
Males
Middle Aged
Mortality Rates
National Health Programs - statistics & numerical data
Patients
Prospective Studies
Renal Dialysis - mortality
Renal Insufficiency, Chronic - mortality
Renal Insufficiency, Chronic - therapy
Risk
Risk Factors
Sex Distribution
Survival Analysis
Survival Rate
Time Factors
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Summary:The aim of this study was to analyze the survival of patients who initiated renal replacement therapy (RRT) with hemodialysis or peritoneal dialysis in the Brazilian Unified National Health System from 2002 to 2004. This was an observational, prospective, non-concurrent study. The study used the National Database for Renal Replacement Therapies resulting from probabilistic matching of Authorization of High-Complexity Procedures/Outpatient Information System and the Mortality Information System. The study included patients admitted in 2002 and 2003, with 3 months of treatment, and 18 years or older. Of the 31,298 patients, the majority: began RRT with hemodialysis, were male, with mean age 54 years, and living in the Southeast region and in municipalities with a mean HDI of 0.78. Increased risk of death was associated with: female gender, age greater than 55 years, diagnosis of diabetes mellitus, peritoneal dialysis, and not residing in the Southeast region. Residing in cities with higher HDI was associated with lower risk. Adjusted risk was HR = 1.17 in favor of hemodialysis. The results suggest shorter survival for peritoneal dialysis and older patients. It is thus necessary to support policies to better evaluate the RRT modality with studies that further elucidate the findings.
ISSN:0102-311X
1678-4464
DOI:10.1590/S0102-311X2012000300002