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Allocation of initial modality for renal replacement therapy in Brazil
Mônica Viegas Andrade1, Jaume Puig Junoy, Eli Iola Gurgel Andrade
1Department of Social and Preventive Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190, sala 706, Belo Horizonte, MG 30130-100, Brazil.
Clinical Journal of the American Society of Nephrology : CJASN
|February 20, 2010
Summary
Patient allocation for end-stage renal disease (ESRD) treatment in Brazil is not random. Factors like sex, diabetes, age, and region influence the choice between hemodialysis (HD) and peritoneal dialysis (PD).
Area of Science:
- Nephrology
- Public Health
- Health Services Research
Background:
- Dialysis modality choice for end-stage renal disease (ESRD) lacks global consensus.
- Understanding initial dialysis modality allocation is crucial for patient care and resource management.
Purpose of the Study:
- To analyze the initial dialysis modality for ESRD patients in Brazil.
- To identify factors influencing patient allocation to hemodialysis (HD) or peritoneal dialysis (PD).
Main Methods:
- Retrospective cohort study using national administrative registries (2000).
- Logistic regression analysis to determine factors associated with HD vs. PD allocation.
- Independent variables included age, sex, diabetes, region, and healthcare supply indicators.
Main Results:
- 88% of 11,563 ESRD patients initiated hemodialysis (HD), while 12% started peritoneal dialysis (PD).
- Male sex and absence of diabetes were associated with higher likelihood of HD initiation.
- Younger and elderly patients had lower probabilities of starting HD; geographic region significantly influenced allocation.
Conclusions:
- Initial dialysis modality allocation for ESRD in Brazil is not random.
- Patient assignment to HD or PD is significantly influenced by individual patient characteristics and healthcare system supply variables.
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