Self-report of medical diagnosis of chronic kidney disease: prevalence and characteristics in the Brazilian adult population, National Health Survey 2013 and 2019

Gouvêa, Ellen de Cassia Dutra Pozzetti; Szwarcwald, Celia Landmann; Damacena, Giseli Nogueira; Moura, Lenildo de

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Brasil

Epidemiologia e Serviços de Saúde

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Original Article • Epidemiol. Serv. Saúde 31 (spe1) • 2022 • https://doi.org/10.1590/SS2237-9622202200017.especial copy

Self-report of medical diagnosis of chronic kidney disease: prevalence and characteristics in the Brazilian adult population, National Health Survey 2013 and 2019

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To estimate the prevalence of chronic kidney disease (CKD) in the adult Brazilian population and to describe its characteristics, according to the National Health Survey (PNS) 2013-2019.

Methods:

Descriptive cross-sectional study, with adults participating in the PNS, based on self-reported medical diagnosis of CKD. Prevalence of CKD and their respective 95% confidence intervals (95%CI) were estimated for Brazil.

Results:

In 2013, 60,202 individuals were analyzed, and in 2019, 85,854. The prevalence of self-reported diagnosis of CKD in both editions was 1.4% and increased with increasing age. In 2019, the prevalence of self-reported CKD was 3.3% (95%CI 2.9;3.7) in hypertensive individuals, 4.1% (95%CI 3.4;5.0) among diabetics, and 3.3% (95%CI 2.8;3.9) in those reporting hypercholesterolemia.

Conclusion:

The prevalence of CKD in Brazil remained stable in the period but reinforces the need for expansion of diagnosis and strengthening of primary care in the Brazilian National Health System (SUS).

Keywords:
Renal Insufficiency Chronic; Risk Factors; Prevalence; Health Surveys

Sociodemographic characteristics	2013 (n = 60,202)			2019 (n = 85,854)
Sociodemographic characteristics	n	%	95%CI^a	n	%	95%CI^a
Total among individuals with a diagnosis of CKD	852	1.4	1.3;1.6	1.261	1.4	1.3;1.6
Sex
Male	381	1.3	1.1;1.6	553	1.3	1.2;1.5
Female	470	1.5	1.3;1.7	708	1.5	1.3;1.7
Age group
18 to 29	82	0.5	0.4;0.7	133	0.7	0.5;1.0
30 to 44	167	0.9	0.7;1.1	253	1.0	0.8;1.2
45 to 59	301	2.0	1.7;2.4	402	1.8	1.5;2.1
60 to 74	209	2.6	2.0;3.2	325	2.4	2.0;2.8
≥ 75	93	3.4	2.2;5.2	148	3.1	2.5;3.9
Race/skin color
White	449	1.6	1.3;1.8	611	1.6	1.4;1.8
Brown	304	1.2	1.0;1.4	129	1.3	1.1;1.5
Black	85	1.5	1.0;2.3	504	1.2	0.9;1.7
Education
No schooling/incomplete elementary education	479	2.0	1.7;2.4	592	2.0	1.7;2.3
Incomplete high school	110	1.2	0.9;1.5	214	1.7	1.3;2.2
Complete high school and over	262	1.0	0.8;1.2	455	1.0	0.9;1.2
Per capita income (minimum wages)
< 1	597	1.4	1.3;1.6	656	1.4	1.2;1.6
1-2	175	1.5	1.2;1.9	344	1.5	1.3;1.8
> 2	80	1.1	0.8;1.6	261	1.4	1.1;1.7

Characterization of the CKD, complications and care		2013 (n = 856)			2019 (n = 1,332)
Characterization of the CKD, complications and care		n	%	95%CI^a	n	%	95%CI^a
Chronic kidneyt disease		852	1.4	1.3;1.6	1,261	1.4	1.3;1.6
Average age at first diagnosis of CKD		-	40.2 SD^b 1.055	38.1;42.2	-	38.8 SD^b 0.994	36.8;40.7
Kidney transplant due to CKD	Yes	17	2.0	1.1;3.6	50	3.9	2.1;7.1
Kidney transplant due to CKD	No	835	98.0	96.4;98.9	1,211	96.1	92.9;97.9
Hemodialysis due to CKD	Yes	63	7.4	4.9;11.0	72	5.6	4.1;7.6
Hemodialysis due to CKD	No	789	92.6	89.0;95.1	1,189	94.4	92.4;95.9
Peritoneal dialysis due to CKD	Yes	13	1.5	0.8;3.0	33	2.5	1.3;5.0
Peritoneal dialysis due to CKD	No	839	98.5	97.0;99.2	1,228	97.5	95.0;98.7
Takes medications due to CKD	Yes	493	57.9	52.3;63.2	658	49.4	44.7;54.0
Takes medications due to CKD	No	359	42.1	36.8;47.7	674	50.6	46.0;55.3
Has regular follow-ups with a health professional due to CKD	Yes	-	-	-	705	56.3	51.6;60.8
	No	-	-	-	556	43.7	39.2;48.4
Degree of limitation of daily life activities due to CKD	No limit	507	59.5	54.1;64.7	759	60.0	55.4;64.4
	A little	168	19.8	15.9;24.3	215	17.6	14.6;21.2
	Moderately	No limit	9.1	6.8;12.1	134	10.4	7.7;13.8
	Intense/Really intense	99	11.7	8.5;15.7	153	12.0	9.4;15.1

Hypertension		2013 (n = 856)			2019 (n = 1,332)
Hypertension		n	%	95%CI^a	n	%	95%CI^a
Hypertension	Yes	368	2.9	2.4;3.4	694	3.3	2.9;3.7
Hypertension	No	484	1.0	0.9;1.2	638	0.9	0.8;1.0
Age at first diagnosis of hypertension	18 to 39	107	2.8	2.1;3.7	221	3.7	2.9;4.7
	40 to 59	168	2.7	2.1;3.4	304	2.8	2.4;3.4
	≥ 60	68	3.2	1.9;5.3	115	3.1	2.3;4.1
Visits a doctor/health care service regularly due to hypertension	Yes, regularly	259	3.4	2.7;4.2	482	3.8	3.2;4.5
	No, only in the event of a problem	79	2.0	1.4;2.7	177	2.7	2.1;3.5
	Never visits a doctor for follow-ups	30	2.5	1.4;4.5	34	1.6	1.0;2.6

Diabetes		2013 (n = 856)			2019 (n = 1,332)
Diabetes		n	%	95%CI^a	n	%	95%CI^a
Diabetes	Yes	129	3.4	2.6;4.5	282	4.1	3.4;5.0
Diabetes	No	773	1.3	1.1;1.5	1,050	1.2	1.1;1.3
Age at first diagnosis of diabetes	18 to 39	13	2.3	1.4;4.0	42	3.6	2.4;5.4
	40 to 59	66	3.3	2.3;4.8	147	4.1	3.1;5.3
	≥ 60	37	3.7	2.0;6.5	83	4.5	3.1;6.4
Visits a doctor/health care service regularly due to diabetes	Yes, regularly	90	3.5	2.5;5.0	222	4.5	3.6;5.6
	No, only in the event of a problem	27	3.1	1.8;5.5	42	3.0	1.9;4.6
	Never visits a doctor for follow-ups	13	3.8	1.7;7.7	19	3.3	1.7;6.4

Diabetes		2013 (n = 856)			2019 (n = 1,332)
Diabetes		n	%	95%CI^a	n	%	95%CI^a
Obesity^b	Yes	190	1.5	1.2;1.9	-	-	-
Obesity^b	No	662	1.4	1.2;1.6	-	-	-
Diagnosis of high cholesterol	Yes	268	3.6	3.0;4.3	425	3.3	2.8;3.9
Diagnosis of high cholesterol	No	527	1.2	1.0;1.4	797	1.2	1.0;1.3
Tobacco smoking	Smoker	172	2.0	1.5;2.5	156	1.4	1.1;1.9
	Former smoker	240	2.3	1.8;2.8	432	1.8	1.6;2.1
	Never smoked	440	1.1	0.9;1.3	673	1.2	1.1;1.4
Among former smokers, how long the individual was a smoker (years)	For up to 5	11	1.0	0.4;2.4	30	1.0	0.6;1.6
	From 6 to 10	15	1.4	0.7;2.8	33	1.3	0.9;2.0
	From 11 to 20	52	2.5	1.7;3.6	76	1.7	1.2;2.5
	≥ 21 years	128	3.3	2.4;4.7	228	2.8	2.3;3.4

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence
Ellen de Cassia Dutra Pozzetti Gouvêa. ellen.gouvea@saude.gov.br