Patients with chronic kidney disease and diabetes mellitus: How is health care?

To evaluate if the recommendations of appropriate health care for Chronic Kidney Disease (CKD) are implemented in patients with Diabetes Mellitus (DM) and Systemic Arterial Hypertension (SAH). This is a descriptive study conducted between January and March 2019 in Divinópolis, in the Brazilian state...

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Published in:Diabetes & metabolic syndrome clinical research & reviews 2019-05, Vol.13 (3), p.2292-2298
Main Authors: Aquino, Jéssica Azevedo, Oliveira, Cláudia Di Lorenzo, Otoni, Alba, Sanches, Cristina, Silva Soares, Paulo Henrique, de Morais, Flávio Augusto, Baldoni, André Oliveira
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Diabetes Mellitus - physiopathology
Disease Progression
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Hypertension, Pulmonary - complications
Male
Middle Aged
Patient Care Management - standards
Patient Care Management - statistics & numerical data
Prognosis
Pulmonary Artery - pathology
Renal Insufficiency, Chronic - etiology
Renal Insufficiency, Chronic - prevention & control
Risk Factors
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Summary:To evaluate if the recommendations of appropriate health care for Chronic Kidney Disease (CKD) are implemented in patients with Diabetes Mellitus (DM) and Systemic Arterial Hypertension (SAH). This is a descriptive study conducted between January and March 2019 in Divinópolis, in the Brazilian state of Minas Gerais. Patients aged 18 years or older with CKD, DM and/or SAH were followed up at the municipal nephrology outpatient clinic. An interview was conducted using a structured questionnaire to assess care, which was categorized as adequate or inadequate, based on the health care recommendations of the national guidelines for care of patients with CKD. 42 participants with CKD participated in the study. All participants had SAH and 42.9% (n = 18) also had DM. It was evidenced that 81.0% (n = 34) of the individuals with CKD had adequate health care, especially among patients in earlier stages (3A and 3B) and those who progressed to renal replacement therapy. However, 80.0% (n = 8) of the participants in the intermediate stage (stage 4) were inadequately followed up by the nephrologist and multidisciplinary team. Patients in intermediate stages do not receive follow-up with a multidisciplinary team at the recommended frequency. The preventive approach of the progression of renal disease in the intermediate stage in the studied municipality was not within the recommendations of the Ministry of Health.
ISSN:1871-4021
1878-0334
DOI:10.1016/j.dsx.2019.05.022