Access to kidney transplant in Brazil: A case of inequity?

Kidney transplant is the best treatment option for carriers of End Stage Renal Disease (ESRD), improving the survival and quality of life. In Brazil, few studies approach the access to this treatment. The objective is describe the profile of the patients who began Renal Substitutive Therapy (RST) in Brazil, between 2000 – 2004 and compare the profile of the transplanted patients and the non transplanted.  This work is inserted in the research “Economic-epidemiological assessment of the RST in Brazil”. The National Data Base in RST  presents records of patients, in the period from 2000 – 2004, resulting from a probabilistic pairing of data from information systems in health, clinical and of mortality, of the Health Public System.  Age, sex, residence region, time between entry in RST and transplant and occurrence of deaths were analyzed.  Between 2000 and 2004, 90.356 individuals entered in RST , 56.7% male, average age 53 years old, the majority residing in the Southeast Region of the country, mainly starting in hemodyalysis (89.5%). The main cause of ESRD was high blood pressure and 42.3% of the patients died.  7.0% had kidney transplant, 59.9% were males, average age at the beginning of the RST 36.6 years old, while the non transplanted patients were 54.3 years old. The Southeast and South geographic regions presented a higher percentage of carrying out transplants, the first one with 8.3% and the second one with 7.8 %. The average time waiting for transplant since the entry in RST was 20 months. During the observation period, 7.1% of transplanted patients, 44.9% of non transplanted patients progressed to death. The majority of the transplanted patients was males, younger than the non transplanted patients and resided in the Southeast and South region. The results indicate demographic and geographic inequity to the access of kidney transplant in Brazil.