Introduction:
In Brazil, Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI) are public health issues with a scarcity of information and population-based studies that could contribute to health policies in the country. Objective: To analyze hospitalization and mortality rates associated with CKD and AKI in Brazil.
Methods:
A national database study using the Hospital Information System of the Unified Health System (SIH-SUS) and the Mortality Information System of SUS (SIM-SUS) from the Department of Informatics of SUS (DATASUS). Data extraction was performed using the R software with the "microdatasus" package. The selected ICD-10 codes ranged from N17.0 to N18.9. The data were stratified by sex and age group (0-19, 20-59, and > 60 years) from January 2008 to December 2023. The population at risk was obtained from the Brazilian Institute of Geography and Statistics (IBGE), and the health insurance coverage rates were provided by the National Supplementary Health Agency (ANS) to adjust the denominator. The equations used were: hospitalizations (numerator) / (IBGE – ANS)*100.000 inhabitants. Mortality rates were calculated using the following equation: deaths (numerator) / (IBGE)*100.000.
Results:
From January 2008 to December 2023, there were 1,645,105 hospitalizations due to kidney disease, with 12.41% resulting in death. Of the total hospitalizations, 45.12% were due to unspecified chronic kidney disease (ICD-10 N18.9); 23.03% were due to unspecified acute kidney injury (ICD-10 N17.9); and 19.93% were due to end-stage renal disease (ICD-10 N18.0). Regarding hospitalization rates for AKI (ICD-10 N17.0 to N17.9), the age group over 60 years showed the highest averages, with values of 7.60 and 4.28 per 100,000 inhabitants for males and females, respectively. For CKD hospitalizations (ICD-10 N18.0 to N18.9), individuals aged 60 years and older had the highest averages, with 19.43 per 100,000 for males and 11.67 per 100,000 for females, followed by the 20-59 age group, with 4.13 and 3.41 per 100,000, respectively. There was a significant increase in AKI rates among the population aged 60 years and older, with an increase of 119.35% for females and 118.28% for males. In the case of CKD, the largest variations occurred among males aged 60 years and older (42.52%) and males aged 20-59 years (42.44%). A total of 184,887 deaths were recorded during the period. Males and females over 60 years old had the highest mortality rates, with 2.15 and 1.26 per 100,000 inhabitants for CKD, respectively. For AKI, we observed average rates of 1.35 and 0.98 per 100,000 for males and females, respectively, in the same age group. There was a 35.79% increase in mortality for males aged 0-19 years due to CKD, while the female population in this age group showed a reduction (-46.48%).
Conclusions:
The presented data show an increase in hospitalizations and mortality among patients with CKD and AKI in Brazil, with a greater impact on the elderly population. The high prevalence of these diseases underscores the importance of effective prevention, diagnosis, and treatment strategies to mitigate their impact on public health.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.