Causas múltiplas de morte associadas à insuficência renal crônica no Brasil: 2000-2004

Abstract

The aim of this study is to investigate mortality from chronic renal failure (CRF) based on multiple causes of death in Brazil between 2000 and 2004. We obtained the patterns of association with other causes to CRF death, revealing the most common patterns in the study population, taking into account demographics characteristics (sex, age and region of residence of the patient at the beginning of treatment. Also the initial modality of renal replacement therapy (RRT) was considered. The analysis of the multiple-cause indicators showed that mortality from CRF would be underestimated by the exclusive use of the underlying cause of death. The Grade of Membership (GoM) method was used in building mortality profiles. Results indicated the existence of four distinct profiles: Profile 1 -Infectious diseases and those related to glomerular and digestive tract - with a prevalence of 8.9%; Profile 2 - Injury, poisoning and other consequences of external causes abnormal reaction or later complication caused by hemodialysis -the most prevalent, 46.7%. Profile 3 - Diabetes and cardiovascular diseases - in which prevalence was lowest among the four, 5.5%. The results suggest that Brazil is facing a preventable morbidity and mortality panoram associated with CRF. A more appropriate and integral care to patients and potential patients and early diagnosis and referral to reduce or stop the progression of the disease are among the key strategies for better outcomes.