Acceptance for chronic dialysis treatment: Insufficient and unequal

Acceptance for chronic dialysis treatment: Insufficient and unequal

Author Sesso, Ricardo de Castro Cintra Autor UNIFESP Google Scholar
Fernandes, Paula Frassinetti Castelo Branco Camurca Google Scholar
Anção, Meide Silva Autor UNIFESP Google Scholar
Drummond, Michael Google Scholar
Draibe, Sergio Antonio Autor UNIFESP Google Scholar
Sigulem, Daniel Autor UNIFESP Google Scholar
Ajzen, Horacio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
AIM PREFEITURA SAO PAULO
Abstract Background. Evidence suggests that a number of end-stage renal disease (ESRD) patients die without receiving dialysis. We investigated and compared ESRD patients who died without receiving treatment and those who were accepted for dialysis.Methods. All patients starting chronic dialysis in 1991 in the city of Sao Paulo and prospectively registered in the Health Secretariat files were studied. From death certificates we obtained data from all patients dying with an underlying cause associated with chronic renal failure. Medical records from a sample of patients who died without receiving dialysis were reviewed.Results. Of 2127 patients, 1582 (74.4%) received dialysis and 545 (25.6%) did not. The best chance of being dialysed occurred in the 20-29 age group. The age groups with the least chance of receiving dialysis were 0-9 years and over 79 years old. The odds ratio (95% Cl) of not receiving dialysis was 12.42 (6.63-23.82) times greater for patients over 60 years old compared to those aged 20-29 years. Patients with renal failure due to congenital diseases, chronic pyelonephritis, unknown cause, and hypertension were less likely to receive dialysis than those with glomerulonephritis or diabetes.Conclusions. Our results suggest that many ESRD patients die without receiving dialysis. Age and cause of renal disease influence the chance of being accepted for treatment. Restrictions of treatment need to be corrected to guarantee that maintenance dialysis will be accessible to ESRD patients.
Keywords dialysis
mortality
chronic renal failure
epidemiology
acceptance
Language English
Date 1996-06-01
Published in Nephrology Dialysis Transplantation. Oxford: Oxford Univ Press United Kingdom, v. 11, n. 6, p. 982-986, 1996.
ISSN 0931-0509 (Sherpa/Romeo, impact factor)
Publisher Oxford Univ Press United Kingdom
Extent 982-986
Origin http://dx.doi.org/10.1093/ndt/11.6.982
Access rights Open access Open Access
Type Article
Web of Science ID WOS:A1996UU40500021
URI http://repositorio.unifesp.br/11600/44988

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