Autor(es): Costa, Cláudia ; Peres, Nadiesda ; Branco, Carolina ; Silva, Bernardo ; Agapito Fonseca, José ; Outerelo, Cristina ; Resina, Cristina ; Melo, Maria João ; Lopes, José António ; Gameiro, Joana
Data: 2024
Origem: Portuguese Kidney Journal (PKJ)
Assunto(s): Africa; Portugal; Renal Dialysis; Renal Insufficiency; Chronic/epidemiology; Chronic/ therapy
Introduction: Africa contributes to <10% of the total renal replacement therapy (RRT) patients worldwide. Due to a co‐ operation protocol, Portugal provides RRT and CKD care to patients from some African Countries of Portuguese Official Language (ACPOL). The purpose of this analysis was to describe the clinical characteristics and outcomes of patients from ACPOL who integrated our hemodialysis (HD) program in Portugal. Methods: Retrospective analysis of 126 African patients who integrated the HD program of a tertiary hospital in Portu‐ gal, between January 2013 and December 2019. Results: Mean age was 49.9 ± 14.1 years, and 56.3% were male (n= 71). Twenty‐one patients came from Angola (16.7%), 53 from Cape Verde (42.0%), 23 from Guinea‐Bissau (18.3%), 20 from Saint Thomas and Prince (15.9%), and 9 from Mo‐ zambique (7.1%). Motives for referral to Portugal were advanced CKD and RRT requirement (n=80, 63.5%), other health condition in patients on HD (n=12, 9.5%), and vascular access dysfunction (n=8, 6.4%). Twenty‐six patients (20.6%) came to Portugal on their own initiative and integrated our HD unit. All patients started HD with a central venous catheter (CVC). Nine patients had end stage VA failure for HD. Mean follow‐up time was 5.8 ± 3.4 years, with 1.6% being transferred to peritoneal dialysis (n=2) and 15.1% being submitted to renal transplantation (n=18). The mortality rate during follow‐up was 14.3% (n=18). Conclusion: This is the first study presenting the clinical characteristics and outcomes of hemodialysis patients from ACPOL. Most of these patients come in need of RRT and due to VA dysfunction, though some patients opt to come to Portugal in search for better HD care. Portugal still has a central role providing HD and vascular access care to CKD patients from ACPOL. Nevertheless, the cornerstone to improve these patients’ quality of life and survival is a proper investment in African countries’ healthcare, financial and educational, namely regarding CKD management and ESRD.
