SciELO - Scientific Electronic Library Online

vol.63 issue2Incontinence-associated dermatitis: a problem without definition, systematic reviewThe family and social environment of the mother as a factor that promotes or hinders breastfeeding author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google


Revista de la Facultad de Medicina

Print version ISSN 0120-0011


SANABRIA-ARENAS, Mauricio et al. Dialysis initiation and mortality in a program for chronic kidney disease prevention in Colombia. [online]. 2015, vol.63, n.2, pp.209-216. ISSN 0120-0011.

Background. Chronic kidney disease (CKD) has been associated with high mortality rate. Preventive programs have been developed to face the burden of this disease worldwide. These programs have proved efficient at achieving better outcomes. In Colombia, a renal facilities network began a secondary preventive program where CKD patients receive multidisciplinary care aimed at controlling mortality and delaying initiation of dialysis. Objective. To determine the frequency of dialysis initiation and mortality in a group of patients older than 18 with advanced CKD, and to evaluate demographic and clinical factors associated with these outcomes. Materials and Methods. In a retrospective cohort study, we evaluated 511 patients with advanced CKD stages 3 to 5, admitted in a preventive program between April 2010 and May 2013. Incidence density rates were calculated. Associations between clinical and demographic factors and outcomes were tested using Cox regression. Results. A total of 551 patients contributed with 1199 years-in-risk; they had a median of 6 visits during follow-up. Out of the total of patients, 301(54.6%) were female; mean age was 75.8 years; main causes of CKD were hypertension for 431 patients (78.2%) and diabetes for 101 (18.3%). Baseline median of glomerular filtration rate (GFR) was 40.9 ml/min/1.73m² and body mass index (BMI) was 22.9 kg/m². Rate of initiation of dialysis was 2.1 per 100 patient-years; other causes of CKD (different to hypertension) and diabetes were better predictors for this outcome; higher GFR and older age were associated with low risk of dialysis initiation. The mortality rate was 2.9 per 100 patient-years; high GFR and high BMI were predictors of low risk for this outcome. The mortality rate was higher than the rate of dialysis initiation. Conclusions. This data confirms that higher GFR results in lower risk for both outcomes, unlike other reports, older age seems to indicate a low risk of mortality, and was not a good predictor for dialysis initiation.

Keywords : Kidney failure; Mortality; Dialysis; Incidence; Risk factors.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )