Prevalência de autorrelato de diagnóstico médico de doença renal crônica no Brasil: Pesquisa Nacional de Saúde, 2013 / Prevalence of self-reported chronic kidney disease in Brazil: National Health Survey of 2013

RESUMO: Objetivo: Descrever o perfil dos adultos que referiram diagnóstico médico de doença renal crônica (DRC), segundo variáveis selecionadas. Métodos: Estudo transversal em que foram incluídos indivíduos entrevistados pela Pesquisa Nacional de Saúde de 2013, estudo de base populacional e domiciliar realizado no Brasil, representativo da zona rural e urbana. Foram avaliados 60.202 indivíduos com idade ≥ 18 anos que referiram diagnóstico médico de insuficiência renal crônica ou doença renal. Foi realizada estatística descritiva, incluindo cálculos de prevalências e respectivos intervalos de confiança de 95% (IC95%). Resultados: A prevalência de DRC foi de 1,4% (IC95% 1,3 - 1,6), semelhantes entre os sexos; masculino: 1,4% (IC95% 1,1 - 1,6) e feminino 1,5% ((IC95% 1,3 - 1,7). A região Sul apresentou a maior frequência desse indicador (2,1%; IC95% 1,6 - 2,7). A prevalência de tratamento dialítico dentre as pessoas com diagnóstico médico autorreferido de DRC foi de 7,4% (IC95% 4,4 - 10,3), sendo maior no sexo masculino (12,4%; IC95% 6,5 - 18,3) e não houve diferença entre as faixas etárias e os níveis de escolaridade. DRC foi referida por 8,9% (IC95% 3,5 - 14,3) dos pardos, sem diferença entre as raças/cor da pele. Conclusão: Esses resultados revelam os diversos aspectos da DRC no país. Observou-se que a distribuição foi desigual, onerando principalmente os de menor escolaridade, o que demanda maior investimento em programas de saúde para o enfrentamento dessa enfermidade. Dessa forma, esses dados permitem direcionar o planejamento de políticas públicas voltadas à prevenção dessa doença e à promoção da saúde.

ABSTRACT: Objective: To describe the profile of adults who reported medical diagnosis of chronic kidney disease (CKD), according to selected variables. Methods: In a cross-sectional study with individuals included in the National Health Survey of 2013, a household population-based study was conducted in rural and urban areas of Brazil. A total of 60,202 individuals aged ≥18 years who self-reported a medical diagnosis of chronic renal failure or kidney disease were evaluated. Descriptive statistics, including calculations of prevalence and 95% confidence intervals (95%CI), were calculated. Results: The prevalence of CKD was 1.4% (95%CI 1.3 - 1.6). It was similar between sexes: male, 1.4% (95%CI 1.1 - 1.6); and female, 1.5% ((95%CI 1.3 - 1.7). southern Brazil showed the highest frequency of this indicator (2.1%; 95%CI 1.6 - 2.7). The prevalence of dialysis among people with medical diagnosis of end stage renal disease was 7.4% (95%CI 4.4 - 10.3), being greater in males (12.4%; 95%CI 6.5 - 18.3). There was no difference between the age groups and schooling levels. CKD was referenced by 8.9% (95%CI 3.5 - 14.3) of the individuals with brown skin, with no difference among races/skin color. Conclusion: These results reveal various aspects of CKD in Brazil. The distribution of CKD was unequal, burdening especially individuals with poor education, demanding greater investments in health programs for the confrontation of CKD. Thus, these data allow the planning of public policies aimed at the prevention of this disease and health promotion.

A política das doenças raras e o SUS

1º módulo do curso de Formação de Teleconsultores sobre a Política Nacional de Atenção Integral às Pessoas com Doenças Raras no SUS. Apresenta informações detalhadas sobre a Portaria GM/MS nº 199, publicada em 12 de fevereiro de 2014, que instituiu a Política Nacional de Atenção Integral às Pessoas com Doenças Raras, aprovou Diretrizes para Atenção Integral às Pessoas com Doenças Raras no âmbito do Sistema Único de Saúde (SUS) e instituiu incentivos financeiros de custeio.

Prevalence of self-reported chronic kidney disease in Brazil: National Health Survey of 2013.

OBJECTIVE: To describe the profile of adults who reported medical diagnosis of chronic kidney disease (CKD), according to selected variables. METHODS: In a cross-sectional study with individuals included in the National Health Survey of 2013, a household population-based study was conducted in rural and urban areas of Brazil. A total of 60,202 individuals aged ≥ 18 years who self-reported a medical diagnosis of chronic renal failure or kidney disease were evaluated. Descriptive statistics, including calculations of prevalence and 95% confidence intervals (95%CI), were calculated. RESULTS: The prevalence of CKD was 1.4% (95%CI 1.3 - 1.6). It was similar between sexes: male, 1.4% (95%CI 1.1 - 1.6); and female, 1.5% ((95%CI 1.3 - 1.7). southern Brazil showed the highest frequency of this indicator (2.1%; 95%CI 1.6 - 2.7). The prevalence of dialysis among people with medical diagnosis of end stage renal disease was 7.4% (95%CI 4.4 - 10.3), being greater in males (12.4%; 95%CI 6.5 - 18.3). There was no difference between the age groups and schooling levels. CKD was referenced by 8.9% (95%CI 3.5 - 14.3) of the individuals with brown skin, with no difference among races/skin color. CONCLUSION: These results reveal various aspects of CKD in Brazil. The distribution of CKD was unequal, burdening especially individuals with poor education, demanding greater investments in health programs for the confrontation of CKD. Thus, these data allow the planning of public policies aimed at the prevention of this disease and health promotion.

Estratégia de cuidado na Atenção Especializada Ambulatorial: qualificação e ampliação do acesso / Care strategy in Secondary Care: qualification and increasing of access

A expansão da Estratégia Saúde da Família (ESF) e a introdução de novos programas de atenção à saúde produziram aumento significativo no acesso da população à Atenção Básica(AB). A Atenção Especializada (AE), entretanto, não se ampliou de forma proporcional. Este artigo teve o objetivo de contextualizar a AE e propor um novo modelo. A AE caracteriza-se pela desarticulação entre os serviços, com modelo centrado nas especialidades, baixo uso de Tecnologias da Informação (TI) e financiamento por procedimentos. Propõe-se a discussão de um novo modelo de AE regionalizada, com critérios territoriais, multiprofissional, centrada nas necessidades do paciente, com uso de ferramentas de TI e nova forma de financiamento.

The expansion of the Family Health Strategy (ESF) and the introduction of new health care programs produced significant increase in the population’s access to Primary Care (AB). The Secondary Care (AE), however, was not increased proportionally. The objective of this study is to contextualize the AE and propose a new care model. The AE is characterized by dismemberment between services, focusing on specialties, low use of Information Technology (IT) and with a funding model based on individual medical procedure payment. It is proposed to discuss a new model of regionalized AE, centered on the patient’s needs, using IT tools and a new form of financing.