Impact of social vulnerability on the outcomes of predialysis chronic kidney disease patients in an interdisciplinary center.

Autor:	Tirapani Ldos S; Universidade Federal de Juíz de Fora, Brasil., Pinheiro HS; Universidade Federal de Juíz de Fora, Brasil., Mansur HN; Fundação Instituto Mineiro de Ensino e Pesquisas em Nefrologia, Brasil., Oliveira Dd; Fundação Instituto Mineiro de Ensino e Pesquisas em Nefrologia, Brasil., Huaira RM; Fundação Instituto Mineiro de Ensino e Pesquisas em Nefrologia, Brasil., Huaira CC; Fundação Instituto Mineiro de Ensino e Pesquisas em Nefrologia, Brasil., Grincenkov FR; Fundação Instituto Mineiro de Ensino e Pesquisas em Nefrologia, Brasil., Bastos MG; Universidade Federal de Juíz de Fora, Brasil., Fernandes NM; Universidade Federal de Juíz de Fora, Brasil.
Jazyk:	English; Portuguese
Zdroj:	Jornal brasileiro de nefrologia [J Bras Nefrol] 2015 Jan-Mar; Vol. 37 (1), pp. 19-26.
DOI:	10.5935/0101-2800.20150004
Abstrakt:	Introduction: Numerous studies examined the associations between socio-demographic, economic and individual factors and chronic kidney disease (CKD) outcomes and observed that the associations were complex and multifactorial. Socioeconomic factors can be evaluated by a model of social vulnerability (SV). Objective: To analyze the impact of SV on the outcomes of predialysis patients. Methods: Demographic, clinical and laboratory data were collected from a cohort of patients with predialysis stage 3 to 5 who were treated by an interdisciplinary team (January 2002 and December 2009) in Minas Gerais, Brazil. Factor, cluster and discriminant analysis were performed in sequence to identify the most important variables and develop a model of SV that allowed for classification of the patients as vulnerable or non-vulnerable. Cox regression was performed to examine the impact of SV on the outcomes of mortality and need for renal replacement therapy (RRT). Results: Of the 209 patients examined, 29.4% were classified as vulnerable. No significance difference was found between the vulnerable and non-vulnerable groups regarding either mortality (log rank: 0.23) or need for RRT (log rank: 0.17). In the Cox regression model, the hazard ratios (HRs) for the unadjusted and adjusted impact of SV on mortality were found to be 1.87 (confidence interval [CI]: 0.64-5.41) and 1.47 (CI: 0.35-6.0), respectively, and the unadjusted and adjusted impact of need for RRT to be 1.85 (CI: 0.71-4.8) and 2.19 (CI: 0.50-9.6), respectively. Conclusion: These findings indicate that SV did not influence the outcomes of patients with predialysis CKD treated in an interdisciplinary center.
Databáze:	MEDLINE
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