Pediatric Chronic Dialysis in Brazil: Epidemiology and Regional Inequalities.

PLoS One 2015 18;10(8):e0135649. Epub 2015 Aug 18.

Sociedade Hospital Samaritano, Sao Paulo, Brazil; Pediatric Division, Federal Univesity of Sao Paulo, Sao Paulo, Brazil.

Introduction: There are few reports in the literature estimating the epidemiologic characteristics of pediatric chronic dialysis. These patients have impaired physical growth, high number of comorbidities and great need for continuous attention of specialized services with high demand for complex and costly procedures.

Objective: The aim of this study was to estimate the incidence and prevalence rates and describe the characteristics of children and adolescents undergoing chronic dialysis treatment in a Brazilian demographic health survey.

Materials And Methods: A cross-sectional study was performed in a representative sample of dialysis centers (nc = 239) that was established from the 2011 Brazilian Nephrology Society Census (Nc = 708). We collected data encompassing the five Brazilian macro-regions. We analyzed the data from all patients under 19 years of age. The sample population consisted of 643 children and adolescents who were on chronic dialysis program anytime in 2012. Data collection was carried out in the dialysis services by means of patients' records reviews and personal interviews with the centers' leaders.

Results: We estimated that there were a total of 1,283 pediatric patients on chronic dialysis treatment in Brazil, resulting in a prevalence of 20.0 cases per million age-related population (pmarp) (95% CI: 14.8-25.3) and an incidence of 6.6 cases pmarp in 2012 (95% CI: 4.8-8.4). The South region had the highest prevalence and incidence rates of patients under dialysis therapy, 27.7 (95% CI: 7.3-48.1) and 11.0 (95% CI: 2.8-19.3) cases pmarp, respectively; the lowest prevalence and incidence rates were found in the North-Midwest region, 13.8 (95% CI: 6.2-21.4), and in the Northeast region, 3.8 (95% CI: 1.4-6.3) cases pmarp, respectively.

Conclusion: Brazil has an overall low prevalence of children on chronic dialysis treatment, figuring near the rates from others countries with same socioeconomic profile. There are substantial differences among regions related to pediatric chronic dialysis treatment. Joint strategies aiming to reduce inequities and improving access to treatment and adequacy of services across the Brazilian regions are necessary to provide an appropriate care setting for this population group.

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135649PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540415PMC
May 2016
12 Reads

Publication Analysis

Top Keywords

chronic dialysis
28
dialysis treatment
16
pediatric chronic
12
cases pmarp
12
dialysis
10
prevalence incidence
8
children adolescents
8
incidence rates
8
95%
6
chronic
6
treatment
5
prevalence
5
therapy 277
4
110 95%
4
brazilian macro-regions
4
data encompassing
4
consisted 643
4
encompassing brazilian
4
95% 28-193
4
macro-regions analyzed
4

References

(Supplied by CrossRef)
Epidemiology of Pediatric Chronic Kidney Disease
V Chadha et al.
Advances in Chronic Kidney Disease 2005
Geographic, ethnic, age-related and temporal variation in the incidence of end stage renal disease in Europe, Canada and the Asia-Pacific region, 1998–2002
Nephrol Dial Transplant 2006
Demographics of paediatric renal replacement therapy in Europe: a report of the ESPN/ERA–EDTA registry
N Chesnaye et al.
Pediatr Nephrol 2014
Chronic Dialysis in Brazil—Report of the Brazilian Dialysis Census, 2011
RCC Sesso et al.
J Bras Nefrol 2012
The right to healthcare: integrity, diversity, and territoriality
PT Ribeiro et al.
Ciência & Saúde Coletiva 2007

Similar Publications