CLINICAL AND ECONOMIC BURDEN OF RENAL FAILURE IN BRAZIL (2014–2024): EVIDENCE AND PUBLIC HEALTH PRIORITIES IN A DEVELOPING COUNTRY

 

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https://storage.unitedwebnetwork.com/files/1099/fa18b9be49a2aef41df7d9fe962143d8.pdf
CLINICAL AND ECONOMIC BURDEN OF RENAL FAILURE IN BRAZIL (2014–2024): EVIDENCE AND PUBLIC HEALTH PRIORITIES IN A DEVELOPING COUNTRY

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CHRISTIANY
ALMEIDA
CHRISTIANY ALMEIDA tiane.cma@gmail.com UFRR Medicina Boa Vista Brazil *
Ana Beatriz Fonseca Aguiar tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Ana Caroline Peixoto Lima tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Andressa Vieira Chaves tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Fernanda Priscyla Silva Sant’Ana Trindade tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Isabele Gomes Fernandes tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Isabella Maravalha Gomes Tavares tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Kalithia Nayara Oliveira Medeiros tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Kauan Pereira da Silva tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Luísa Monteiro Leite tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Maria Clara Cruz Pereira tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Maria Gabriela Cavalcante Ribeiro Maia tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Rafaela Lopes Xavier tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Rannyer Victor Silva Aguiar tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -
Ana Luiza Almeida Batista Rocha tiane.cma@bol.com.br UFRR Medicina Boa Vista Brazil -

Acute or chronic kidney failure leads to progressive loss of renal function, with significant clinical and economic repercussions and marked regional inequalities. The objective was to quantify the clinical and economic burden of a decade of hospitalizations for kidney failure in Brazil, characterizing the patients’ social profile, the costs to the Unified Health System (SUS), and regional differences over the period 2014–2024.

Descriptive, retrospective study with a quantitative approach, using data from the SUS Hospital Information System (SIH) on hospitalizations for kidney failure between 2014 and 2024. Variables analyzed: number of hospitalizations, hospital costs, sex, age group, and color/race. Complete records were included, and incomplete or blank information was excluded. Absolute and relative frequencies were analyzed in Microsoft Excel.

The analysis from 2014 to 2024 identified 1,315,857 hospitalizations for kidney disease in Brazil, revealing a substantial increase over the period. The annual number rose from 98,220 cases in 2014 to 156,756 in 2024, representing growth of approximately 59%. The Southeast region concentrated 46.1% of hospitalizations due to the greater population density of urbanized cities and in line with global trends in habits that increase renal risk (stress, dehydration, and processed foods). However, the largest proportional growth occurred in the North, with a 136.2% increase, which may be associated with improvements in notification and diagnostic systems in more remote regions of the country. Regarding economic cost, there was a marked increase across all regions, doubling over ten years: from 63.45M (Millions) to 116.92 M in 2024, totaling nearly $925M for the period. The North (+206%) and Center-West (+151.6%) showed the largest increases, while the Southeast accounted for 48.8% of expenditures, reflecting its population density and high-complexity network. The 50–59 age group accounted for the highest costs in all regions, except in the Northeast (60–69 years), indicating delayed access to diagnosis and treatment. Regarding sex, men accounted for 57.3% of hospitalizations (753,532 cases), a pattern repeated in all regions, possibly due to lower preventive adherence and greater exposure to risk factors. In terms of color/race, individuals identifying as Brown (38.9%) and White (35.1%) predominated, totaling 74% of hospitalizations.

There was a substantial increase in the volume of hospitalizations and in hospital costs for kidney failure over the period, with spending growing faster than hospitalizations and an increase in the average cost per admission. The concentration of hospitalizations and expenditures in the Southeast contrasts with the higher proportional growth in the North and Center-West, signaling regional asymmetries. The male predominance and the greater economic burden in middle age indicate critical windows for early detection and timely management. The findings support prioritizing prevention policies and strengthening the continuum of care, focusing on reducing inequities and mitigating the economic impact on SUS.

Kewords