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Chronic Kidney Disease (CKD) represents a public health challenge in Brazil. In a country of continental dimensions, there are numerous gaps in nephrology care, with primary care being the only alternative for patient management. Efforts are being made to optimize the number of consultations and reduce absenteeism rates in specialized medical services across Brazil. Despite high demand, available slots are insufficient to meet the needs, resulting in elevated absenteeism rates in referral services. Nephrological care faces a similar situation, with a substantial demand for consultations with nephrologists, yet many slots remain unutilized.
All consultations conducted in the adult nephrology screening outpatient clinic at the Hospital das Clínicas of the Federal University of Minas Gerais (HC-UFMG) were documented between October 2022 and October 2023. The chi-square test was employed for analysis, considering p < 0.05 as statistically significant.
Over the course of one year, 395 users were scheduled for consultations. Out of these, 268 attended, while 127 were absent. The elderly (> 65 years) exhibited the highest absenteeism rate (p<0.01). The majority of absent patients resided in the municipality of Belo Horizonte (59 records). Among attendees, the primary referral cause was Multifactorial Disease, encompassing Diabetic Kidney Disease with Hypertensive Nephrosclerosis, totaling 39.5%. A total of 236 patients (88%) required ongoing nephrological monitoring, primarily for advanced stages of CKD (42.5% at or above stage G3b and 20.9% above G4). 10.8% of patients without conditions requiring specialized nephrological care were referred back to primary care.
The absenteeism rate in our specialized nephrology service is high, with patient age being a contributing factor. Despite appropriate patient referrals in most cases, a significant proportion of patients presented with decompensated CKD causes during evaluation.