Evidence mapPaperPMID 40660076Full record

ArticleInternational urology and nephrology2026

Registry of access to chronic dialysis initiation at the Public Health System in Brazil.

Farid Samaan, Áurea Maria Izabel Clemente, Raquel Zaicaner, Gianna Mastroianni Kirsztajn, Ricardo Sesso

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In one paragraph

Article in International urology and nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Farid SamaanPlanning Group, State Department of Health of São Paulo, 351 Dr. Arnaldo Avenue, 5th Floor, São Paulo, SP, 01246-000, Brazil. fsamaan@saude.sp.gov.br.
Áurea Maria Izabel ClementeRegulation Group, State Department of Health of São Paulo, 351 Dr. Arnaldo Avenue, 5th Floor, São Paulo, SP, 01246-000, Brazil.
Raquel ZaicanerRegulation Group, State Department of Health of São Paulo, 351 Dr. Arnaldo Avenue, 5th Floor, São Paulo, SP, 01246-000, Brazil.
Gianna Mastroianni KirsztajnNephrology Division, Federal University of São Paulo, 783 Borges Lagoa Street, 6th Floor, São Paulo, SP, 04038901, Brazil.
Ricardo SessoNephrology Division, Federal University of São Paulo, 783 Borges Lagoa Street, 6th Floor, São Paulo, SP, 04038901, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe aim to analyze the requests for the initiation of kidney replacement therapy (KRT) in the public health system of the state of São Paulo, Brazil.

methodsInitial KRT requests sent to the Regulation Center of the State Department of Health between 01/01/2023 and 12/31/2024 were evaluated. KRT initiation was considered "planned" if it occurred outside the hospital environment or the patient started hemodialysis (HD) with an arteriovenous fistula (AVF).

resultsA total of 8451 individuals from 17 healthcare macroregions were included [median interquartile range (IQR)] age: 62 (51-71) years; male sex: 60%; etiology of CKD: 57% hypertension and 21% diabetes). Conservative predialysis treatment of CKD was implemented for 26% of patients in the state, ranging from 4 to 44% in the macroregions. The percentage of patients initiating HD with AVF was 10% (variation in macroregions: 4-25%), and people who initiated KRT in hospital were 70% (37-94%). The initial modality was HD in 95% of the patients (range: 73-100%) (peritoneal dialysis in 5% [(0-27%)], and the median waiting time for a KRT slot vacancy was 12 (IQR: 6-29) days (1 (1-4) to 31 (14-75) in macroregions). Multiple regression analysis revealed that conservative treatment of CKD was independently associated with planned initiation of KRT (odds ratio [OR] [95% confidence interval (CI) = 4.99 (4.48-5.54); p < 0.001].

conclusionThe results demonstrate the need to adopt actions to implement pre-dialysis care for people with CKD and to mitigate regional inequalities in access to chronic dialysis in this population.

Indexed as

Health Services AccessibilityKidney Failure, ChronicRegistriesRenal DialysisRenal Insufficiency, ChronicAgedBrazilFemaleHumansMaleMiddle AgedPublic HealthArteriovenous fistulaChronic kidney diseaseHealth information systemsHealth services accessibilityKidney replacement therapyUnified health system

Identifiers

PMID40660076

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.