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  • 1
    Online Resource
    Online Resource
    Characteristics and predictors of mortality on haemodialysis in Brazil: a cohort of 5,081 incident patients
    Springer Science and Business Media LLC ; 2022
    In:  BMC Nephrology Vol. 23, No. 1 ( 2022-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-12)
    Abstract: Although Brazil has one of the largest populations on haemodialysis (HD) in the world, data regarding patients’ characteristics and the variables associated with risk of death are scanty. Methods This is a retrospective analysis of all adult patients who initiated on maintenance HD at 23 dialysis centres in Brazil between 2012 and 2017. Patients were censored after 60 months of follow-up or at the end of 2019. Results A total of 5,081 patients were included in the analysis. The median age was 59 years, 59.4% were men, 37.5% had diabetes as the cause of kidney failure. Almost 70% had a central venous catheter (CVC) as the initial vascular access, about 60% started dialysis in the hospital, and fluid overload (FO) by bioimpedance assessment was seen in 45% of patients. The 60-month survival rate was 51.4%. In the Cox regression analysis, being older ( P 〈 0.0001), starting dialysis in the hospital ( P =0.016), having diabetes as the cause of kidney failure ( P =0.001), high alkaline phosphatase ( P =0.005), CVC as first vascular access ( P =0.023), and FO ( P 〈 0.0001) were associated with higher death risk, whereas higher body mass index ( P =0.015), haemoglobin ( P =0.004), transferrin saturation ( P =0.002), and serum albumin ( P 〈 0.0001) were associated with better survival. The same variables, except initial CVC use ( P =0.14), were associated with death risk in an analysis of subdistribution proportional hazards ratio including the competing outcomes. Conclusions The present study gives an overview of a large HD population in a developing country and identifies the main predictors of mortality, including some potentially modifiable ones, such as unplanned initiation of dialysis in the hospital and fluid overload.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-022-02705-x
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041348-8
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  • 2
    Online Resource
    Online Resource
    Sobrevida na hemodiálise no Brasil de acordo com a fonte pagadora do tratamento: Sistema Único de Saúde versus convênio privado
    FapUNIFESP (SciELO) ; 2023
    In:  Brazilian Journal of Nephrology
    Details
    In: Brazilian Journal of Nephrology, FapUNIFESP (SciELO)
    Abstract: ABSTRACT Introduction: Brazil has the largest public and universal healthcare system in the world, but little is known about the outcomes of patients on hemodialysis (HD) in the country according to the source of funding for the treatment. Objective: To compare the profile and survival of patients under HD treatment funded by the Public Healthcare System (SUS) to those with private insurance. Methods: Retrospective analysis of adults undergoing HD between 2012 and 2017 in 21 dialysis centers in Brazil that provided both by the SUS and private health insurance. Participants, regardless of the paying source, received similar dialysis treatment. Data were censored after 60 months of follow-up or at the end of 2019. Results: 4,945 patients were included, 59.7% of which were financed by the SUS. Patients financed by SUS, compared to those with private insurance, were younger (58 vs. 60 years; p 〈 0.0001) and with a lower prevalence of diabetes (35.8% vs. 40.9%; p 〈 0.0001). The 60-month survival rates in these groups were 51.1% and 52.1%, respectively (p = 0.85). In the analysis of the subdistribution proportional hazard ratio by the Fine-Gray model, including adjustment for concurrent outcomes, a significant increase in the risk ratio for death was found (1.22 [95% confidence interval 1.04 to 1.43]) in patients with treatment funded by the SUS. Conclusions: Patients on HD with treatment funded by the SUS have a higher adjusted risk of death when compared to those with private insurance, despite similar dialysis treatment. Factors not directly related to dialysis therapy could explain this difference.
    Type of Medium: Online Resource
    ISSN: 2175-8239 , 0101-2800
    Uniform Title: Survival in hemodialysis in Brazil according to the source of payment for the treatment: Public Healthcare System (SUS) versus private insurance
    URL: Article
    DOI: 10.1590/2175-8239-jbn-2022-0131pt
    Language: Portuguese , English
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2023
    detail.hit.zdb_id: 2057873-8
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  • 3
    Online Resource
    Online Resource
    Survival in hemodialysis in Brazil according to the source of payment for the treatment: Public Healthcare System (SUS) versus private insurance
    FapUNIFESP (SciELO) ; 2023
    In:  Brazilian Journal of Nephrology
    Details
    In: Brazilian Journal of Nephrology, FapUNIFESP (SciELO)
    Abstract: Resumo Introdução: O Brasil possui o maior sistema público e universal de saúde do mundo, mas pouco se sabe sobre os desfechos dos pacientes em hemodiálise (HD) no país de acordo com a fonte de financiamento do tratamento. Objetivo: Comparar o perfil e a sobrevida dos pacientes que têm o tratamento de HD custeado pelo Sistema Único de Saúde (SUS) com aqueles com convênio privado. Métodos: Análise retrospectiva dos adultos incidentes em HD entre 2012 e 2017 em 21 centros de diálise no Brasil que atendiam tanto pelo SUS quanto por convênios privados. Os participantes, independentemente da fonte pagadora, receberam tratamento dialítico semelhante. Os dados foram censurados com 60 meses de acompanhamento ou ao final de 2019. Resultados: Foram incluídos 4945 pacientes, sendo 59,7% financiados pelo SUS. Os pacientes financiados pelo SUS, em comparação aos que tinham convênio privado, eram mais jovens (58 vs 60 anos; p 〈 0,0001) e com menor prevalência de diabetes (35,8% vs 40,9%; p 〈 0,0001). As taxas de sobrevida, em 60 meses nesses grupos foram de 51,1% e 52,1%, respectivamente (p = 0,85). Na análise da razão de risco proporcional de subdistribuição pelo modelo de Fine-Gray, incluindo ajuste para desfechos concorrentes, foi encontrado um aumento significativo na razão de risco para morte (1,22 [intervalo de confiança de 95% 1,04 a 1,43]) nos pacientes com tratamento custeado pelo SUS. Conclusões: Pacientes em HD com tratamento custeado pelo SUS têm um risco ajustado de morte mais elevado do que aqueles com convênio privado, apesar do tratamento dialítico semelhante. Fatores não relacionados diretamente à terapia dialítica poderiam justificar esta diferença.
    Type of Medium: Online Resource
    ISSN: 2175-8239 , 0101-2800
    Uniform Title: Sobrevida na hemodiálise no Brasil de acordo com a fonte pagadora do tratamento: Sistema Único de Saúde versus convênio privado
    URL: Article
    DOI: 10.1590/2175-8239-jbn-2022-0131en
    Language: English , Portuguese
    Publisher: FapUNIFESP (SciELO)
    Publication Date: 2023
    detail.hit.zdb_id: 2057873-8
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  • 4
    Online Resource
    Online Resource
    Patient perception of vitality and measured physical activity in patients receiving haemodialysis
    Wiley ; 2020
    In:  Nephrology Vol. 25, No. 11 ( 2020-11), p. 865-871
    Details
    In: Nephrology, Wiley, Vol. 25, No. 11 ( 2020-11), p. 865-871
    Abstract: This cross‐sectional study evaluates the association between patient perception of chronic and post‐dialysis fatigue and physical activity. Vitally was found to be associated with physical activity, while dialysis recovery time was not shown to be associated with physical activity within the two hours after a haemodialysis session.
    Type of Medium: Online Resource
    ISSN: 1320-5358 , 1440-1797
    URL: Issue
    URL: Article
    DOI: 10.1111/nep.v25.11
    DOI: 10.1111/nep.13758
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2008235-6
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