Profile, follow-up adherence and progression of people with advanced chronic kidney disease in specialized care centers: a retrospective study, Santa Catarina state, Brazil, 2021-2024.

OBJECTIVES: To characterize the profile of people with advanced chronic kidney disease treated in specialized outpatient centers and to describe adherence to follow-up and assess the impact of specialized follow-up by comparing the glomerular filtration rate at baseline and after one year of follow-up. METHODS: This was a retrospective multicenter study that included people with stage 4 and 5 chronic kidney disease treated between November 2021 and October 2024, in five specialized outpatient centers in Santa Catarina state. The 12-month follow-up rate and changes in kidney function were assessed through the estimated glomerular filtration rate of people who started follow-up by October 2023. RESULTS: Of the 547 people cared for during the study period, 83.0% were at stage 4 of the disease, 80.6% were elderly (>60 years), 91.8% had hypertension, 51.6% had diabetes and 65.6% were overweight or obese. Of the 237 people who started follow-up by October 2023, 211 (90.2%) completed one year of follow-up. The median estimated glomerular filtration rate remained stable during the period (22 [18-26] versus 22 [18-27] ml/min/1.73m2; p-value 0.300). Five people (2.1%) progressed to renal replacement therapy. CONCLUSION: The population served was predominantly elderly and presented multiple risk factors for progression of chronic kidney disease. The high follow-up rate over one year and the preservation of kidney function reinforced the importance of specialized follow-up in the care of people with advanced chronic kidney disease.