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T�tulo:

VALIDA��O DAS CAUSAS DE DOEN�A RENAL CR�NICA TERMINAL NO MUN�CIPIO DE FORTALEZA- CE

Autor(es):

SARMENTO, LUANA RODRIGUES

Palavras Chaves:

N�o informado

Ano de Publica��o:

2016

Resumo:

RESUMO
Doen�a renal cr�nica (DRC) � um problema de sa�de p�blica devido sua alta
incid�ncia e ao elevado custo da terapia de substitui��o renal. O conhecimento das
causas de DRC � fundamental para tra�ar estrat�gias preventivas, para determina��o
de progn�stico e para estabelecer a melhor conduta para o paciente renal cr�nico.
Objetivou-se investigar as causas de DRC, validar os diagn�sticos dos pacientes
dial�ticos e calcular o percentual de concord�ncia entre as causas antes e ap�s a
valida��o. Estudo transversal, anal�tico, de car�ter quantitativo, baseado na an�lise
dos prontu�rios de pacientes em hemodi�lise de 5 centros especializados no
munic�pio de Fortaleza, no per�odo de 01/08/2015 a 31/07/2016. Foram exclu�dos os
casos de �bito no per�odo da coleta e os transferidos para outras unidades fora do
munic�pio em quest�o. Coletou-se dados de 830 prontu�rios, restando 818 ap�s
aplica��o dos crit�rios de exclus�o. Observou-se que 61,1% dos pacientes eram do
sexo masculino. A faixa et�ria mais prevalente foi de 60 a 69 anos, 22% (180). A idade
m�dia foi de 55,7 � 16anos. Antes da valida��o, a hipertens�o prim�ria (HAS) foi a
causa mais frequente de DRCT, com 22,9% e ap�s valida��o caiu para 3,8%. A causa
mais comum de DRCT p�s-valida��o foi indeterminada, 35,3%; seguida por, diabetes
mellitus (DM), 26,4%; doen�a renal polic�stica do adulto (DRPA) com 6,2%; fal�ncia
do enxerto, 6,2%; uropatia obstrutiva, 5,7%; e glomerulonefrite prim�ria, 5,3%. A
discord�ncia entre os diagn�sticos (pr� e p�s) valida��o foi de 39,6% e o Kappa global
foi moderado (k=0,51). Os dados contrariam estudos nacionais que afirmam que a
primeira causa de DRCT seria hipertens�o prim�ria. Evidenciou-se a alta taxa de
causas desconhecidas, e um vi�s de classifica��o, principalmente com rela��o a HAS
prim�ria como causa de DRCT, o que afeta a preval�ncia geral das causas de DRCT
dos pacientes em di�lise. H� necessidade de padroniza��o nacional e internacional
para os crit�rios de HAS como causa prim�ria de DRCT. Pode-se inferir que esses
dados s�o valiosos para a literatura cient�fica e fomentar� uma abordagem
diferenciada com rela��o ao paciente renal cr�nico.
Descritores: Doen�a renal cr�nica. Doen�a renal cr�nica terminal. Estudos de
valida��o. Sa�de coletiva.

Abstract:

ABSTRACT
Chronic kidney disease (CKD) is a public health problem due to its high incidence and
high costs of renal replacement therapy (RRT). The knowledge of the causes from
CKD is fundamental to design preventive strategies, to determine prognosis and to
establish the best strategies for chronic renal patients management. The aim of this
study was to investigate the causes of CKD, to validate the diagnoses of dialysis
patients and to calculate the agreement between the causes before and after the
validation. This is an analytical, retrospective study based on data collected from the
medical records of patients undergoing haemodialysis from five specialized centres in
Fortaleza city (Northeast of Brazil), from 08/01/2015 to 07/31/2016.There were
excluded patients who dialysis was paid by private in surance health, those who died,
and those transferred to other dialysis units outside the municipality in question. A total
of 830 medical records were collected and 818 were included after the exclusion
criteria was applied. It was observed that 61.1% were male; the most prevalent age
group was between 60 to 69 years old (22%; n=180); the mean age was 55.7 � 16 yo.
Before the validation, primary hypertension was the first cause of ESRD, 22.9%, and
after validation it decreased to 3.8%. The most common cause of ESRD post-validation
was undetermined cause, 35.3%; followed by DM, 26.4%; APKD, 6,2%;graft
failure,6.2%; obstructive uropathy, 5.7%; and primary glomerulonephritis, 5.3%. The
total disagreement between the pre and post-validation diagnoses was 39.6% and the
overall kappa was moderate (k = 0.51). In contrast to national studies data, which
reports that the first cause of ESRD is primary hypertension. The high rate of unknown
causes and a classification bias, especially with respect to primary hypertension as a
cause of CKD, were observed, which affects the overall prevalence of the causes of
ESRD in dialysis patients. There is a need for national and international
standardization for SAH criteria as the primary cause of ESRD. It can be inferred that
these data are valuable for the scientific literature and will foment
a differentiated approach with respect to the chronic renal patient.
Descriptors: Chronic kidney insufficiency. End stage renal disease. Validation studies.
Public health.

Tipo do Trabalho:

Disserta��o

Refer�ncia:

SARMENTO, LUANA RODRIGUES. VALIDA��O DAS CAUSAS DE DOEN�A RENAL CR�NICA TERMINAL NO MUN�CIPIO DE FORTALEZA- CE . 2016. 71 f. Disserta��o (Mestrado Acad�mico ou Profissional em 2016) - Universidade Estadual do Cear�, , 2016. Dispon�vel em: <http://siduece.uece.br/siduece/trabalhoAcademicoPublico.jsf?id=83060> Acesso em: 18 de maio de 2024

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