Permanent vascular access in patients with end-stage renal disease, Brazil

Revista de Saúde Pública

Gisele Macedo Da Silva²  Isabel Cristina Gomes¹  Eli Iola Gurgel Andrade²  Eleonora Moreira Lima¹  Francisco De Assis Acurcio¹  Mariângela Leal Cherchiglia² 

[1] ,Universidade Federal de Minas Gerais Faculdade de Medicina Departamento de Medicina Preventiva e SocialBelo Horizonte MG ,Brasil

关键词: Arteriovenous Fistula;    Health Services Accessibility;    Renal Dialysis;    Renal Insufficiency;    Chronic;    Cross-Sectional Studies;    Fístula Arteriovenosa;    Acesso aos Serviços de Saúde;    Diálise Renal;    Insuficiência Renal Crônica;    Estudos Transversais;    Fístula Arteriovenosa;    Accesibilidad a los Servicios de Salud;    Diálisis Renal;    Insuficiencia Renal Crónica;    Estudios Transversales;   

DOI  :  10.1590/S0034-89102011005000005

来源: SciELO

【 摘 要 】

OBJECTIVE: To assess factors associated with the establishment of permanent vascular access for patients with end-stage renal disease. METHODS: Cross-sectional study conducted in a nationally representative sample of Brazilian end-stage renal disease patients in dialysis and transplant centers during 2007. The sample comprised only patients who received hemodialysis as a primary therapy modality and reported the type of vascular access for their primary hemodialysis treatment (N=2,276). Data were from the TRS Project - "Economic and Epidemiologic Evaluation of Modalities of Renal Replacement Therapy in Brazil". Multiple logistic regression analysis was used to assess factors associated with the establishment of permanent vascular access in these patients. RESULTS: About 30% of the patients studied had an arteriovenous vascular access. The following factors were associated with a lower likelihood of having an arteriovenous vascular access as a primary type of access: time of hemodialysis start since the diagnosis of chronic renal failure < 1 year; shorter dialysis therapy; having no private health insurance; living in the central-western, northeastern and southeastern regions of Brazil; and living in the northern region plus having no private health insurance. In the final model there was found a positive association between the outcome and pre-dialysis care and no were association with socioeconomic and comorbidity variables. CONCLUSIONS: The study results showed that the focus should on pre-dialysis care to increase the establishment of an arteriovenous vascular access before starting hemodialysis in Brazil.

【 授权许可】

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