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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
In Brazil, the rising incidence of end-stage chronic renal disease (CKD) contrasts with the limited number of population-based studies on pre-dialysis CKD. This gap limits early risk stratification and dialysis planning, both of which are essential for improving outcomes and optimizing healthcare resources. This study aimed to evaluate the results of a university-based pre-dialysis care program in a metropolitan region of Brazil.
We conducted a prospective cohort study of patients with CKD referred to a public tertiary pre-dialysis care service in the Sistema Unico de Saude. During follow-up, all patients were actively informed about the need for planned vascular access, immunization for hepatitis B virus, and the modalities of renal replacement therapy (RRT). Counseling for optimal blood pressure (<140x90mmHg), glycemic control (HbA1c<7%), and smoking cessation was coupled with nutritional support and medication prescription such as SGLT2i. Results were compared with historical records from the Metropolitan area of Contagem, Minas Gerais, Brazil collected from 2012 to 2025. Cox proportional regression model and log-rank test were used to adjust survival curves. The study was approved by the Committee on Ethics in Research UFMG (CAAE: 74781423.0.0000.5149).
From April 2016 to June 2025, 729 patients (mean age 63.3 ± 17.2 years; 55.0% male) attended a total of 3,692 outpatient nephrology visits. Follow-up visits were scheduled twice a year for patients with CKD stages I–III (n = 261; 35.8%), every three months for those with stage IV (n = 375; 51.4%), and monthly for patients with stage V (n = 93; 12.7%). Eighty-one patients were discharged to primary care due to a low risk of progression (<10% Kidney Failure Risk Equations - KFRE), while 10 patients chose palliative care. Diabetes mellitus type 2 was the most common cause of CKD (n = 204; 28.7%). Among patients with stage IV and V CKD, 18% (n=84) achieved HBV immunization. After a mean follow-up time of 15.6 months (range 0 to 110.6 months), RRT was initiated in 139 patients. In stage V CKD, 23% (n=21) had a functioning arteriovenous fistula, contrasting with data from the local metropolitan area, where most patients 94.8% (n=2,765) started RRT during hospitalization in acute or intensive care, and a double-lumen dialysis catheter was used as the initial vascular access (96.1%; n=2,765). Five-year RRT-free survival was 76.4% (95% CI 57.9–87.6%) for stage III CKD, 60.7% (95% CI 50.6–69.4%) for stage IV CKD, and 10.4% (95% CI 2.1–26.4%) for stage V CKD (Figure 1).
In this metropolitan cohort, a university-based program enabled timely referral, risk stratification, vaccination, vascular access planning, and the integration of palliative care when appropriate. Patients under this care were more likely to initiate RRT with a functioning fistula, less likely to require emergency dialysis, and low-risk individuals were safely transitioned to primary care. These findings demonstrate that structured pre-dialysis management improves outcomes and optimizes resource use for CKD patients.
