Toxicidad financiera en personas con enfermedad renal crónica en tratamiento de hemodiálisis

Silva, Emanuele Cristina de Sousa; Mantovani, Maria de Fátima; Nogueira, Luciana de Alcantara; Küchler, Mahara Louise; Cassi, Christian Carla Aparecida Volski; Kalinke, Luciana Puchalski

Emanuele Cristina de Sousa Silva Corresponding author: Emanuele Cristina de Sousa Silva E-mail: mannukrys@gmail.com

conception or design of the study and analysis and/or interpretation of data

final revision with critical and intellectual participation in the manuscript

Universidade Federal do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0002-1129-3334

Maria de Fátima Mantovani

conception or design of the study and analysis and/or interpretation of data

final revision with critical and intellectual participation in the manuscript

Universidade Federal do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0001-7961-8273

Luciana de Alcantara Nogueira

conception or design of the study and analysis and/or interpretation of data

final revision with critical and intellectual participation in the manuscript

Universidade Federal do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0002-5985-7418

Mahara Louise Küchler

final revision with critical and intellectual participation in the manuscript

Universidade Federal do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0002-7180-0625

Christian Carla Aparecida Volski Cassi

final revision with critical and intellectual participation in the manuscript

Universidade Federal do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0003-3220-8650

Luciana Puchalski Kalinke

final revision with critical and intellectual participation in the manuscript

Universidade Federal do Paraná. Curitiba, Paraná, Brazil

https://orcid.org/0000-0003-4868-8193

Corresponding author: Emanuele Cristina de Sousa Silva E-mail: mannukrys@gmail.com

EDITOR IN CHIEF: Dulce Barbosa

ASSOCIATE EDITOR: Fátima Helena do Espírito Santo

	Cost
	Mean	SD	*p value^ * P value extracted from the analysis of variance (ANOVA) table.**
UNIT			0.0256
Unit 1	16.82	8.10
Unit 2	20.98	8.06
Unit 3	21.34	9.81
Unit 4	21.42	8.31
Total	20.30	8.69

	Financial Toxicity Degrees
	No degree		Mild degree		Moderate degree		High degree
	(n=61)	95%CI	(n=102)	95%CI	(n=50)	95%CI	(n=1)	95%CI
Sex
Female	20	32.8% (22.3-45.3)	47	46.1% (36.7-55.7)	30	60.0% (46.2-72.4)	0	0.0% (0.0-79.3)
Male	41	67.2% (54.7-77.7)	55	53.9% (44.3-63.3)	20	40.0% (27.6-53.8)	1	100.0% (20.7-100.0)
Age
18 to 60	19	31.1% (20.9-43.6)	49	48.0% (38.6-57.6)	32	64.0% (50.1-75.9)	1	100.0% (20.7-100.0)
60 and over	42	68.9% (56.4-79.1)	53	52.0% (42.4-61.4)	18	36.0% (24.1-49.9)	0	0.0% (0.0-79.3)
Marital status
Single	8	13.1% (6.9-24.2)	15	14.7% (9.1-22.9)	13	26.0% (15.9-39.6)	0	0.0% (0.0-79.3)
Married or common-law marriage	37	60.7% (49.0-72.9)	55	53.9% (44.3-63.3)	21	42.0% (29.4-55.8)	1	100.0% (20.7-100.0)
Separated/divorced/widowed	15	24.6% (15.8-37.2)	31	30.4% (22.3-39.9)	16	32.0% (20.8-45.8)	0	0.0% (0.0-79.3)
Not reported	1	1.0% (0.0-6.0)	1	1.0% (0.2-5.3)	0	0.0% (0.0-7.1)	0	0.0% (0.0-79.3)
Education
< 9	30	49.2% (37.1-61.4)	63	61.8% (52.1-70.6)	23	46.0% (33.0-59.6)	1	100.0% (20.7-100.0)
9 to 12	14	23.0% (14.2-34.9)	20	19.6% (13.1-28.4)	15	30.0% (19.1-43.8)	0	0.0% (0.0-79.3)
13 to 16	12	19.7% (11.6-31.3)	11	10.8% (6.1-18.3)	3	6.0% (2.1-16.2)	0	0.0% (0.0-79.3)
>16	2	3.3% (0.9-11.2)	4	3.9% (1.5-9.7)	3	6.0% (2.1-16.2)	0	0.0% (0.0-79.3)
Not reported	3	4.9% (1.7-13.5)	4	3.9% (1.5-9.7)	6	12.0% (5.6-23.8)	0	0.0% (0.0-79.3)
Type of cost of treatment
Private	12	19.7% (11.6-31.3)	19	18.6% (12.3-27.3)	14	28.0% (17.5-41.7)	0	0.0% (0.0-79.3)
SUS	49	80.3% (68.7-88.4)	83	81.4% (72.7-87.7)	36	72.0% (58.3-82.5)	1	100.0% (20.7-100.0)
Family income monthly
Less than 1 MW	0	0.0% (0.0-5.9)	12	11.8% (6.9-19.4)	14	28.0% (17.5-41.7)	0	0.0% (0.0-79.3)
1 to 2 MW	7	11.5% (5.7-21.8)	28	27.5% (19.7-36.8)	15	30.0% (19.1-43.8)	1	100.0% (20.7-100.0)
2 to 3 MW	17	27.9% (18.2-40.2)	22	21.6% (14.7-30.5)	9	18.0% (9.8-30.8)	0	0.0% (0.0-79.3)
3 to 4 MW	6	9.8% (4.6-19.8)	10	9.8% (5.4-17.1)	1	2.0% (0.4-10.5)	0	0.0% (0.0-79.3)
4 to 5 MW	3	4.9% (1.7-13.5)	2	2.0% (0.5-6.9)	2	4.0% (1.1-13.5)	0	0.0% (0.0-79.3)
5 MW or more	13	21.3% (12.9-33.1)	5	4.9% (2.1-11.0)	1	2.0% (0.4-10.5)	0	0.0% (0.0-79.3)
Not reported	15	24.6% (15.5-36.7)	23	22.5% (15.5-31.6)	8	16.0% (8.3-28.5)	0	0.0% (0.0-79.3)

	Financial Toxicity Degrees
	No degree		Mild degree		Moderate degree		High degree
	(n=61)	95%CI	(n=102)	95%CI	(n=50)	95%CI	(n=1)	95%CI
Comorbidities accompanying CKD
Yes	49	80.3% (68.7-88.4)	84	82.4% (73.8-88.5)	41	82.0% (69.2-90.2)	1	100.0% (20.7-100.0)
No	11	18.0% (10.4-29.5)	18	17.6% (11.5-26.2)	9	18.0% (9.8-30.8)	0	0.0% (0.0-79.3)
Not reported	1	1.6% (0.3-8.7)	0	0.0% (0.0-3.6)	0	0.0% (0.0-7.1)	0	0.0% (0.0-79.3)
CKD family history
No	56	91.8% (82.2-96.4)	87	85.3% (77.1-90.9)	42	84.0% (71.5-91.7)	1	100.0% (20.7-100.0)
Yes	5	8.2% (3.6-17.8)	14	13.7% (8.4-21.7)	7	14.0% (7.0-26.2)	0	0.0% (0.0-79.3)
Not reported	0	0.0% (0.0-5.9)	1	1.0% (0.2-5.3)	1	2.0% (0.4-10.5)	0	0.0% (0.0-79.3)
Time since CKD diagnosis (years)
< 1	8	13.1% (6.8-23.8)	9	8.8% (4.7-15.9)	6	12.0% (5.6-23.8)	0	0.0% (0.0-79.3)
1 to 5	30	49.2% (37.1-61.4)	50	49.0% (39.5-58.6)	22	44.0% (31.2-57.7)	0	0.0% (0.0-79.3)
6 to 10	11	18.0% (10.4-29.5)	20	19.6% (13.1-28.4)	13	26.0% (15.9-39.6)	1	100.0% (20.7-100.0)
>10	12	19.7% (11.6-31.3)	23	22.5% (15.5-31.6)	9	18.0% (9.8-30.8)	0	0.0% (0.0-79.3)
Hemodialysis duration (years)
< 1	13	21.3% (12.9-33.1)	15	14.7% (9.1-22.9)	9	18.0% (9.8-30.8)	0	0.0% (0.0-79.3)
1 to 5	37	60.7% (48.1-71.9)	62	60.8% (51.1-69.7)	27	54.0% (40.4-67.0)	1	100.0% (20.7-100.0)
6 to 10	5	8.2% (3.6-17.8)	9	8.8% (4.7-15.9)	8	16.0% (8.3-28.5)	0	0.0% (0.0-79.3)
> 10	6	9.8% (4.6-19.8)	14	13.7% (8.4-21.7)	6	12.0% (5.6-23.8)	0	0.0% (0.0-79.3)
Not reported	0	0.0% (0.0-5.9)	2	2.0% (0.5-6.9)	0	0.0% (0.0-7.1)	0	0.0% (0.0-79.3)
Number of weekly hemodialysis
2 times	3	4.9% (1.7-13.5)	0	0.0% (0.0-3.6)	0	0.0% (0.0-7.1)	0	0.0% (0.0-79.3)
3 times	55	90.2% (80.2-95.4)	99	97.1% (91.7-99.0)	48	96.0% (86.5-98.9)	1	100.0% (20.7-100.0)
more than 3 times	3	4.9% (1.7-13.5)	3	2.9% (1.0-8.3)	2	4.0% (1.1-13.5)	0	0.0% (0.0-79.3)
Continuous medication use
Yes	55	90.2% (80.2-95.4)	88	86.3% (78.3-91.6)	44	88.0% (76.2-94.4)	1	100.0% (20.7-100.0)
No	5	8.2% (3.6-17.8)	14	13.7% (8.4-21.7)	6	12.0% (5.6-23.8)	0	0.0% (0.0-79.3)
Not reported	1	1.6% (0.3-8.7)	0	0.0% (0.0-3.6)	0	0.0% (0.0-7.1)	0	0.0% (0.0-79.3)

Variables	OR	95%redCI	adjusted OR	95%redCI
Intercept			2.60	1.99; 3.37
Sex
Female	1.00	Ref.	1.00	Ref.
Male	0.81	0.70; 0.93	0.85	0.74; 0.98
Age
18 to 60	1.00	Ref.	1.00	Ref.
60 and above	0.85	0.74; 0.98	0.89	0.76; 1.03
Marital status
Single	1.00	Ref.	1.00	Ref.
Married or common-law marriage	0.86	0.70; 1.05	0.93	0.71; 1.20
Separated/divorced/widowed	0.98	0.78; 1.22	0.94	0.73; 1.23
Number of children
0	1.00	Ref.	1.00	Ref.
1 to 3	1.08	0.88; 1.34	1.14	0.87; 1.50
more than 3	1.13	0.89; 1.43	1.13	0.84; 1.55
Education
< 9	1.00	Ref.	1.00	Ref.
9 to 12	0.98	0.83; 1.17	0.97	0.82; 1.16
13 or more	0.85	0.70; 1.03	0.95	0.78; 1.17
Cost of treatment
SUS	1.00	Ref.	1.00	Ref.
Private	1.01	0.83; 1.23	1.01	0.83; 1.21
Number of people living in the residence
1	1.00	Ref.	1.00	Ref.
2	0.82	0.66; 1.01	0.97	0.77; 1.21
3	0.99	0.79; 1.24	1.16	0.92; 1.48
4 or more	0.98	0.79; 1.21	1.05	0.82; 1.35
Monthly family income
Less than 2 MW	1.00	Ref.	1.00	Ref.
2 or more	0.73	0.64; 0.83	0.76	0.65; 0.88

[1] Corresponding author: Emanuele Cristina de Sousa Silva E-mail: mannukrys@gmail.com

Brasil

Brasil

Toxicidad financiera en personas con enfermedad renal crónica en tratamiento de hemodiálisis

RESUMEN

Objetivo:

Método:

Resultados:

Conclusión: