Pre-dialysis chronic kidney disease progression over 4 years in the context of the Public Health System in Brazil: is ethnicity a factor?
Introduction: The prevalence of chronic kidney disease (CKD) significantly increased, and populations with high social vulnerability tend to have worse CKD progression. Objective: To evaluate the impact of ethnicity on the control of pre-dialytic CKD in a Brazilian Unified Health System interdisciplinary outpatient clinic. Material and Methods: Data of 1,992 CKD patients were retrospectively collected from August/2010 to December/2014. Patients referred by primary health care, <18 years, ≥ two consultations were included. Sociodemographic data were collected upon admission; clinical and laboratory data were obtained at each consultation. Patients were divided into groups according to skin colour (self-identified). A descriptive analysis was performed; variables were compared using ANOVA, chi-square or Mann-Whitney U tests. Variables associated with the delta of the estimated glomerular filtration rate (eGFR) were evaluated using linear regression, adjusting for confounding variables. Results: 25.1% were black, 34.4% brown, and 40.5% white. Approximately 51.2% had income ≤ two minimum wages, 84.8% had low level education, 14.0% were illiterate. Black patients were younger and had lower education level; they had higher systolic blood pressure, total cholesterol, high-density lipoproteins, intact parathyroid hormone; their haemoglobin and vitamin D were lower. The median annual eGFR loss was 0 (P25 −6.70, P75 +8.76), 36.5% had rapid eGFR loss (<5 ml/min/year). Only use of angiotensin-converting enzyme inhibitors and low proteinuria were determined as significant for the outcome (RR: 0.92, CI: 0.010–0.684, p=0.02; RR: 0.8, CI: 0.998-0.999, p=0.001). Conclusion: Ethnicity did not impact CKD progression, even though black patients presented clinical and sociodemographic characteristics associated with worse disease progression..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
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| Enthalten in: |
HU Revista - 47(2021) |
| Sprache: |
Englisch ; Portugiesisch |
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| Beteiligte Personen: |
Luciana dos Santos Tirapani Dalamura [VerfasserIn] |
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| Links: |
doi.org [kostenfrei] |
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| Themen: |
Disease Progression |
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| doi: |
10.34019/1982-8047.2021.v47.34181 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
DOAJ010271694 |
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| 520 | |a Introduction: The prevalence of chronic kidney disease (CKD) significantly increased, and populations with high social vulnerability tend to have worse CKD progression. Objective: To evaluate the impact of ethnicity on the control of pre-dialytic CKD in a Brazilian Unified Health System interdisciplinary outpatient clinic. Material and Methods: Data of 1,992 CKD patients were retrospectively collected from August/2010 to December/2014. Patients referred by primary health care, <18 years, ≥ two consultations were included. Sociodemographic data were collected upon admission; clinical and laboratory data were obtained at each consultation. Patients were divided into groups according to skin colour (self-identified). A descriptive analysis was performed; variables were compared using ANOVA, chi-square or Mann-Whitney U tests. Variables associated with the delta of the estimated glomerular filtration rate (eGFR) were evaluated using linear regression, adjusting for confounding variables. Results: 25.1% were black, 34.4% brown, and 40.5% white. Approximately 51.2% had income ≤ two minimum wages, 84.8% had low level education, 14.0% were illiterate. Black patients were younger and had lower education level; they had higher systolic blood pressure, total cholesterol, high-density lipoproteins, intact parathyroid hormone; their haemoglobin and vitamin D were lower. The median annual eGFR loss was 0 (P25 −6.70, P75 +8.76), 36.5% had rapid eGFR loss (<5 ml/min/year). Only use of angiotensin-converting enzyme inhibitors and low proteinuria were determined as significant for the outcome (RR: 0.92, CI: 0.010–0.684, p=0.02; RR: 0.8, CI: 0.998-0.999, p=0.001). Conclusion: Ethnicity did not impact CKD progression, even though black patients presented clinical and sociodemographic characteristics associated with worse disease progression. | ||
| 650 | 4 | |a Renal Insufficiency, Chronic | |
| 650 | 4 | |a Ethnic Groups | |
| 650 | 4 | |a Noncommunicable Diseases | |
| 650 | 4 | |a Disease Progression | |
| 653 | 0 | |a Medicine (General) | |
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| 700 | 0 | |a João Eduardo Cascelli Schelb Scalla Pereira |e verfasserin |4 aut | |
| 700 | 0 | |a Rosália Maria Nunes Henriques Huaira |e verfasserin |4 aut | |
| 700 | 0 | |a Neimar da Silva Fernandes |e verfasserin |4 aut | |
| 700 | 0 | |a Priscylla Aparecida Vieira Carmo |e verfasserin |4 aut | |
| 700 | 0 | |a Natalia Maria da Silva Fernandes |e verfasserin |4 aut | |
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