Funcionamentos básicos de pacientes com doença renal crônica: o impacto da terapia de substituição renal

Abstract

Chronic kidney disease (CKD) is one of the chronic non-communicable diseases (NCDs) that are among the main public health problems in Brazil and worldwide. It is a disease that has a prolonged, insidious course and is asymptomatic for most of its evolution. These facts have a direct impact on prognosis and treatment. This study sought to recognize the possible basic functioning of patients with chronic kidney disease undergoing renal replacement therapy, from the perspective of bioethical justice, the Functioning Perspective, due to the need to individualize and value the subjects. The specific objectives were: 1) To identify in the literature the impact of CKD on the lives of patients undergoing renal replacement therapy; 2) To describe a possible list of basic functions for patients with CKD, based on a theoretical survey of the impacts of renal replacement therapy on these patients; 3) To discuss the relationship between the realization of basic functions and public policies for patients with CKD undergoing renal replacement therapy. The methodological approach is centered on an integrative literature review with a time frame of publications from 2014 to 2024. A search was carried out in the following databases: LILACS via BVS; Scopus; Web of Science; in the Scielo magazine directory and in the Periódico CAPES portal. The following descriptors were used: chronic renal failure; patients; renal replacement therapy; health care; experience reports; emotions; patients; quality of life. A total of 23 studies were included. We identified multifaceted impacts that are interrelated. We highlight the impacts on gender roles and sexuality; on physical condition; on food restriction and water intake; on psychological and emotional condition; and on the social dimension. From the impacts of renal replacement therapy, it was possible to understand the possible basic functions for patients with CKD. In addition, it was identified that health policies do not meet the needs of these patients. In order to meet the multiple health demands, it is necessary to draw up policies aimed at the flourishing of individuals.