Author:

• LETÍCIA KRAUSS SILVA - Krauss Silva, L - RIO DE JANEIRO, RJ - ESCOLA NACIONAL DE SAÚDE PÚBLICA/FIOCRUZ - <leticiak@ensp.fiocruz.br>

Co-author(s):

• Mariane Branco Alves - Branco Alves, M - IM/UFRJ - <marianebranco@gmail.com>
• Rachel Bregman - Bregman, R - Depto Nefrologia/UERJ - <bregmanr@terra.com.br>
• Beatriz Leimann - Leimann, B - ENSP/FIOCRUZ - Subsecret. Vigilância em Saúde/SES-RJ - <leimann@centroin.com.br>
• Dulce Lessi - Lessi, D - Instituto Est. Cardiologia Aloysio de Castro/SES-RJ - <dulcelessi@hotmail.com>

Thematic Area:

Não Categorizado

Abstract:

Chronic kidney disease progresses with renal failure and the need for renal replacement therapy (RRT). Secondary prevention may postpone end-stage renal disease for many years. The present, retrospective, study intended to analyze prognostic factors and to estimate the mortality of patients with kidney failure secondary to diabetes mellitus and to hypertension that initiate RRT through non-elective hemodialysis at an emergency hospital unit in Rio de Janeiro, from hospital admission until transfer to referral units. The mortality rate was 35.1%. The study found a significant difference between the survival curves according to disease etiology (log-rank and Peto, p=0.02) and the presence of functional arteriovenous fistule (log-rank, p=0.0099; Peto, p=0.0090). Multivariate analysis (Cox model) showed a 7% increase in the risk of death (p=0.002) by one-year increment in age; the presence of a functional fistule was associated to an 81% reduction in the risk of death (p=0.03). About one third of patients with kidney failure secondary to hypertension or diabetes that initiate renal replacement therapy through non-elective hemodialysis die before being transferred to a referral unit, indicating low access to secondary prevention activities.

Keywords:

end stage renal disease secondary prevention renal dialysis mortality diabetes mellitus hypertension

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