GESTÃO DA DOENÇA RENAL CRÓNICA EM UTENTES COM DIABETES MELLITUS TIPO 2 NUMA UNIDADE DE SAÚDE FAMILIAR

Abstract

Introduction: Chronic kidney disease (CKD) is a common complication of type 2 diabetes mellitus (T2DM) and is associated with increased cardiovascular risk, higher morbidity, mortality, and a substantial socioeconomic burden. Early diagnosis and timely initiation of appropriate therapy are essential to slow disease progression and reduce cardiovascular events.
Objective: To evaluate the clinical management of CKD in patients with T2DM followed in a Primary Health Care Unit, with particular emphasis on diagnostic coding, clinical control, and optimization of cardiovascular protective therapies.
Methods: A retrospective, cross-sectional study was conducted based on the analysis of clinical records of patients with T2DM and CKD followed at USF da Luz. Sociodemographic and clinical variables were collected. The prescription of drugs with proven cardiorenal benefit—angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACE inhibitors/ARBs), sodium–glucose cotransporter–2 (SGLT2) inhibitors and finerenone—was assessed, as well as therapeutic changes after CKD coding.
Results: This study found that the prevalence of CKD among patients with T2DM was 39.4%. Only 27.1% of patients with CKD had a formally coded diagnosis. Patients with coded CKD were older (mean age 81.8 vs. 79.1 years), had higher serum creatinine levels (1.41 vs. 1.03 mg/dL) and lower estimated glomerular filtration rate (42.1 vs. 56.1 mL/min), reflecting more advanced stages of kidney disease. Prescription of ACE inhibitors/ARBs at maximal doses and SGLT2 inhibitors was more frequent in patients with coded CKD.
Conclusion: CKD coding was associated with more appropriate therapeutic optimization and may contribute to a reduction in cardiorenal risk. These findings underline the importance of formal CKD registration and an integrated cardiorenal approach in primary care.