Hemodialysis and its financing in Brazil

Abstract

Introduction: Chronic Kidney Disease is defined as the progressive and irreversible loss of kidney function. Data established by the Brazilian Society of Nephrology (SBN), published in 2023, showed that by 2022 there were more than 150 thousand patients undergoing dialysis treatment in Brazil. Despite its relevance, insufficient funding for Renal Replacement Therapy (RRT) has generated increasing challenges to ensure adequate care for chronic kidney patients, especially given the increased demand and complexity of treatment. Objective: This report seeks to highlight the impacts of underfunding on clinical practice and the experience at the James Fanstone Foundation, highlighting initiatives that can contribute to strengthening the system and showing state and municipal investments as potential solutions to improve renal health care. Methodology: Experience report based on experiences during the Nephrology rotation at the James Fanstone Foundation in Anápolis and in the specialty’s outpatient clinics, carried out during the Internal Medicine residency. Results: The diagnosis of Chronic Kidney Disease can be made based on routine exams in patients with chronic diseases such as diabetes and hypertension. Soon after, together with the nephrologist, the type of treatment, type of vascular access and request for a place in the municipal dialysis clinics are defined. However, the investment from the SUS table does not cover all the expenses generated by RRT. Currently, some Brazilian states assist with funds to supplement the financing of hemodialysis, which has brought great benefits to patients. Conclusion: It is necessary to increase investments in hemodialysis sessions and clinics in the country, with the objective of improving care for chronic kidney patients and increasing their quality and life expectancy.