Allocation of Initial Modality for Renal Replacement Therapy in Brazil

Allocation of Initial Modality for Renal Replacement Therapy in Brazil

Autor Andrade, Monica Viegas Google Scholar
Puig Junoy, Jaume Google Scholar
Andrade, Eli Iola Gurgel Google Scholar
Acurcio, Francisco de Assis Google Scholar
Sesso, Ricardo Autor UNIFESP Google Scholar
Queiroz, Odilon Vanni de Google Scholar
Szuster, Daniele Araujo Campos Google Scholar
Gomes, Isabel Cristina Autor UNIFESP Google Scholar
Almeida, Alessandra Maciel Google Scholar
Cherchiglia, Mariangela Leal Google Scholar
Instituição Universidade Federal de Minas Gerais (UFMG)
Pompeu Fabra Univ
Universidade Federal de São Paulo (UNIFESP)
Resumo Background and objectives: the use of dialysis modalities for ESRD varies around the world. There is no consensus in literature regarding the most appropriate choice of dialysis method. the aim of this study was to analyze the initial modality for ESRD in Brazil and evaluate the factors determining patients' allocation to either hemodialysis (HD) or peritoneal dialysis (PD).Design, setting, participants, & measurements: A retrospective cohort study was performed using national administrative registries of all patients financed by the public system who began renal replacement therapy in 2000 in Brazil. Logistic regression analysis was used to investigate factors associated with the probability of receiving HD or PD at the start of treatment. Independent variables tested were age, sex, presence of diabetes, geographic region of residence, and health care supply indicators.Results: of 11,563 patients analyzed, 88% started on HD and 12% started on PD. Patients were more likely to be assigned to HD if they were male (odds ratio: 1.44; 95% confidence interval: 1.23 to 1.68) and nondiabetic (odds ratio: 0.71; 95% confidence interval: 0.60 to 0.84). With regard to age, the youngest and the elderly showed lower probability of being in HD. in addition, the state of residence at the start of treatment was very important to explain initial modality allocation.Conclusions: Our findings suggest that patient allocation in Brazil is not random. the probability of allocation to HD or PD is highly associated with individual attributes and supply variables. Clin J Am Soc Nephrol 5: 637-644, 2010. doi: 10.2215/CJN.04840709
Idioma Inglês
Financiador Brazilian Health Ministry
Brazilian National Council for Scientific and Technological Development
Foundation for Research Support of the State of Minas Gerais
Data de publicação 2010-04-01
Publicado em Clinical Journal of the American Society of Nephrology. Washington: Amer Soc Nephrology, v. 5, n. 4, p. 637-644, 2010.
ISSN 1555-9041 (Sherpa/Romeo, fator de impacto)
Publicador Amer Soc Nephrology
Extensão 637-644
Fonte http://dx.doi.org/10.2215/CJN.04840709
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000276585000013
Endereço permanente http://repositorio.unifesp.br/handle/11600/32395

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