A NATIONWIDE NEPHROPROTECTION PROGRAM AND ITS IMPACT ON DIALYSIS TRANSITION IN COLOMBIA: TRADITCO STUDY

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A NATIONWIDE NEPHROPROTECTION PROGRAM AND ITS IMPACT ON DIALYSIS TRANSITION IN COLOMBIA: TRADITCO STUDY

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Co-author 1

Peter Rutherford peter.rutherford@vantive.com Vantive corporation Medical Affairs Zurich Switzerland *

Co-author 2

Mauricio Sanabria mauricio.sanabria@vantive.com Renal Care Services Latin-America Medical Affairs Bogota Colombia -

Co-author 3

Sergio Paez spaezm@unal.edu.co National University of Colombia Department of Statistics Bogota Colombia -

Co-author 4

Jasmin Vesga jasmin.vesga@vantive.com Renal Care Services Colombia Medical Affairs Bucaramanga Colombia -

Co-author 5

Angela Rivera angela.rivera@vantive.com Vantive corporation Medical Affairs Deerfield United States -

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Introduction

Since the early 2000s, Colombia has implemented a nationwide Chronic Kidney Disease (CKD) prevention and nephroprotection program integrating primary and specialized care. The program aims to slow progression, promote timely referrals, and ensure safe, planned transitions to dialysis therapy.

Methods

A retrospective cohort study was performed, including 2,829 patients with CKD stage G5 who were enrolled in the Renal Care Services (RCS) Nephroprotection Program in Colombia from 2016 to 2023. The patients were followed for one year, and the follow-up period was extended to 90 days for those who started dialysis. Descriptive statistics and a time-to-event analysis were performed.

Results

A total of 2,829 adult patients were followed for one year. Of these, 1,471 required dialysis, 13 received kidney transplants, and 1,345 remained in stage G5. The characteristics of this cohort are detailed in Table 1. The program's effectiveness based on planned dialysis initiation was 64.5%. The estimated median dialysis-free survival was 121 days (interquartile range: 55, 217), see Figure 1. Additionally, 54% of patients initially chose peritoneal dialysis, which increased to 64% within the first 90 days. Furthermore, we found that patients who started dialysis unplanned had a higher death proportion during the first 90 days: 5.4%, compared with 1.8% in the planned group (p-value = 0.01), see Figure 2.

Table 1. Demographic and clinical characteristics of the study population.

Figure 1. The estimated median dialysis-free survival

Conclusion

The Colombian nephroprotection program effectively supports early detection and coordinated management of advanced CKD, facilitating planned transitions to dialysis and increased uptake of peritoneal dialysis.

Kewords