TEN YEARS OF TUBULOINTERSTITIAL DISEASE IN BRAZIL (2014–2024): EPIDEMIOLOGICAL PROFILE, ECONOMIC IMPACT, AND IMPLICATIONS FOR PUBLIC POLICY

Tubulointerstitial Disease (TID) represents an insidious threat to global renal health, manifesting as inflammation that can culminate in severe kidney failure. Whether acute in origin—driven by infections and medication reactions—or chronic—linked to autoimmune diseases, toxins, and prolonged drug use—TID demands vigilance and in-depth understanding. In developing nations like Brazil, its complex epidemiology and public health impact remain underestimated, challenging already overburdened healthcare systems and calling for more effective preventive, diagnostic, and therapeutic interventions. This study aims to unveil the epidemiological landscape of TID in Brazil, offering crucial temporal and demographic analysis to inform public policies and global health strategies.

This study adopted a descriptive and retrospective design with a quantitative approach, aiming to analyze the profile of hospitalizations due to Tubulointerstitial Disease (TID) across Brazil's macro-regions from 2014 to 2024. Data were meticulously extracted from the Hospital Information System of the Unified Health System (SIH/SUS), a public domain database. For the identification of TID cases, relevant International Classification of Diseases (ICD-10) codes were utilized. Variables collected included the number of hospitalizations, total hospital expenditure, sex, age group, and race/color of patients. Incomplete or inconsistent information was excluded from the analysis to ensure data reliability. The data underwent descriptive statistical analysis, summarizing the absolute and relative frequencies of the studied variables, to characterize the epidemiological profile and economic impact of TID during the period.

Results indicated an approximate 34% reduction in total TID hospitalizations over the last decade, decreasing from 90,069 in 2014 to 59,434 in 2024. This decrease may suggest an improvement in health promotion, possibly reflecting the strengthening of Primary Health Care. A female predominance was noted (521,128 cases), potentially associated with a higher risk of urinary tract infections, medication consumption, and the incidence of autoimmune diseases. The highest prevalence occurred among those aged 20 to 29 years (133,332 cases), suggesting a population burden in regions with greater exposure to occupational and environmental factors. The Brown (287,492 cases) and White (275,241 cases) populations represented the majority, a distribution consistent with the Brazilian demographic profile. A progressive increase in hospitalization expenditure for TID was observed across all macro-regions, from R$36 million in 2014 to R$49 million in 2024, totaling over R$423 million in the decade. This elevated cost demonstrates the significant economic impact of the disease on the healthcare system.

In summary, the study highlights the influence of occupational and environmental factors, greater female vulnerability due to immunological and hormonal aspects and drug use, and the significant incidence of TID in young adults. Given the considerable economic burden and complex epidemiological profile, the implementation of strategic public policies is imperative, focusing on primary prevention, epidemiological surveillance, and early diagnosis, particularly in workplaces. Collaboration and international data sharing are thus essential for the development of new strategies and clinical guidelines aimed at global renal function protection.