Health Needs Assessment: Chronic Kidney Disease Secondary to Type 2 Diabetes Mellitus in a Population without Social Security, Mexico 2016-2032

• Published in: International journal of environmental research and public health Vol. 19; no. 15; p. 9010
• Main Authors: Martínez-Valverde, Silvia, Zepeda-Tello, Rodrigo, Castro-Ríos, Angélica, Toledano-Toledano, Filiberto, Reyes-Morales, Hortensia, Rodríguez-Matías, Adrián, Durán-Arenas, Juan Luis Gerardo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 25.07.2022; MDPI
• Subjects: Adults; Age groups; Analysis; Cardiovascular diseases; Chronic kidney failure; Cohort Studies; Development and progression; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus - epidemiology; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Diabetics; Fatalities; Health care; Health risks; Health services; Humans; Kidney diseases; Kidneys; Markov chains; Markov processes; Mathematical models; Mexico - epidemiology; Needs analysis; Patients; Population (statistical); Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - etiology; Risk; Risk Factors; Simulation models; Social Security; Stochasticity; Type 2 diabetes; Mexico; United States > US; health needs; assessment; Mexico; chronic kidney disease; diabetes mellitus; Markov model
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph19159010

Health needs assessment is a relevant tracer of planning process of healthcare programs. The objective is to assess the health needs of chronic kidney disease (CKD) secondary to type 2 diabetes mellitus (T2 DM) in a population without social security in Mexico. The study design was a statistical simulation model based on data at the national level of Mexico. A stochastic Markov model was used to simulate the progression from diabetes to CKD. The time horizon was 16 years. The results indicate that in 2022, kidney damage progression and affectation in the diabetic patient cohort will be 34.15% based on the time since T2 DM diagnosis. At the end of the 16-year period, assuming that the model of care remains unchanged, early renal involvement will affect slightly more than twice as many patients (118%) and cases with macroalbuminuria will triple (228%). The need for renal replacement therapy will more than double (169%). Meanwhile, deaths associated with cardiovascular risk will more than triple (284%). We concluded that the clinical manifestations of patients with CKD secondary to T2 DM without social security constitute a double challenge. The first refers to the fact that the greatest health need is early care of CKD, and the second is the urgent need to address cardiovascular risk in order to reduce deaths in the population at risk.