Preditores de mortalidade em pacientes submetidos à diálise no Brasil: uma revisão integrativa.

Abstract

INTRODUCTION: Chronic kidney disease is a topic of great relevance in Brazil because of its high morbidity and mortality profile, high and increasing incidence and prevalence and huge costs to public coffers, especially when it comes to dialysis methods. OBJECTIVE: To investigate, alongside scientific literature, the predictors that impact the survival of patients with chronic kidney disease undergoing dialysis methods in Brazil. METHOD: This is an integrative literature review that used the MEDLINE, SciELO, LiLACS and BVS platforms to search for articles dating from January 2009 until July 2019, through a specific combination of pre-selected keywords. about mortality predictors for dialysis patients in Brazil. 15 articles were selected and evaluated to provide predictors of mortality, of wich were 14 cohort studies and 1 case series. RESULTS AND DISCUSSION: 29 predictors were found with different levels of evidence. However, the most frequently cited and reiterated points by statistical methods, especially multivariate analysis, as predictors of higher mortality were advanced age, diabetes mellitus, low serum albumin, presence of cardiovascular disease, use of venous catheter at the beginning of dialysis and low hemoglobin and hematocrit levels. Other predictors are cited, but have conflicting results or are still emerging points in the medical literature, requiring further studies for their consolidation. CONCLUSION: A common limitation to many of the studies was the lack of information about certain variables in the patients' medical records, besides, the laboratory variables did not obtain assertive standardization when defining their reference values. The results presented in this study better reflects predictors of hemodialysis. We hope this study help other researchers discern which clinical, sociodemographic, and laboratory variables are relevant for evaluation in further research.