EVALUATION OF THE PRIMARY CARE IN THE PREVENTION OF KIDNEY DISEASES IN PATIENTS WITH SYSTEMIC ARTERIAL HYPERTENSION AND DIABETES MELLITUS: PERSPECTIVE OF USERS OF THE UNITED HEALTH SYSTEM

Abstract

Introduction: kidney disease is in an ascending line of prevalence and systemic arterial hypertension (SAH) and diabetes mellitus (DM) are the underlying diseases that most affect the kidneys. The preventive approach is the main action to mitigate the complications of this disease. Objective: to evaluate, from the user's perspective, the institutional capacity of Primary Health Care (PHC) to act with the prevention of chronic kidney disease in people with SAH and DM. Method: analytical cross-sectional study developed in a municipality in the Midwest of Minas Gerais between the years 2021 and 2022. Sociodemographic data were collected and a validated instrument for Portuguese “Patient Assessment of Chronic Illness Care/PACIC” was applied. Descriptive, bivariate, and multivariate logistic regression analysis was performed. Results: 68 patients participated in the research, 44 of whom were hypertensive, 11 with DM and 25 with both morbidities. As PACIC results, the maximum score (five) was represented in three of the five domains studied: “Active Participation of the Patient in the Treatment”; “Care System Model/Practice Model” and “Problem Solving/Context”, but the median scores of these same domains were 1.7; 2.7 and 1.5 respectively. The minimum score (one) was observed in all five domains studied, including “Goal Setting/Adaptation” and “Follow-up/Coordination”, in addition to those already mentioned. When analyzing all domains simultaneously, the median of the overall PACIC was 2.0. Conclusion: from the user's perspective, there is an inadequate institutional capacity of PHC in the preventive approach of kidney disease in people with SAH and DM.