Geografia da diálise peritoneal no Brasil: análise de uma coorte de 5.819 pacientes (BRAZPD)

Abstract

Introduction: Brazil is a continental country with great diversity of population, social and cultural. This factor may determine different demographic, clinical and outcome presented by patients with chronic kidney disease on peritoneal dialysis (PD). Objective: To evaluate the clinical characteristics and outcomes presented by PD patients in different regions of Brazil, analyzing a cohort of patients (BRAZPD) in the period 12/2004 to 10/2007. Patients and Methods: Data were collected monthly and patients were followed until the outcome (death, renal transplantation, renal function recovery, transfer to hemodialysis or loss of followup). Results: We evaluated 5.819 patients incident and prevalent. Most patients performed renal replacement therapy (RRT) in the Southeast, where the average follow up time was longer (12.3 months) and there is a higher percentage of elderly (36.4%). The prevalence of diabetes is higher in Southeast and South (38.1% and 37%, respectively). Most patients in the North region had previously hemodialysis (66.2%). The mortality was higher in the Northern region (30.1%), as well as failure of the technique (22.3%). Conclusion: The data shows different demographic, clinical, mortality and technique failure of PD reflecting the demographic and social peculiarities of Brazil. The geography of the DP in Brazil proves to be a mirror of the geography of Brazil. So health policies should take into account the characteristics of each region so we can improve patient survival and technique on peritoneal dialysis.