O Dia Mundial do Rim, celebrado este ano no 14 de março, serve para discutir com a sociedade sobre as doenças renais, seu tratamento e prevenção. Temos inúmeros tipos de disfunção dos rins, mas quero abordar uma condição silenciosa, comum e letal: a doença renal crônica.
A condição acomete cerca de 10% da população mundial, e é definida pela perda de função gradual e progressiva da capacidade dos rins de filtrar as impurezas do sangue. O diabetes e a pressão alta, principalmente se mal controlados, são as principais causas do problema no Brasil e no mundo.
Importante lembrar que a obesidade por si só é um fator de risco para a queda de função dos rins. Outro fator causador é o tabagismo.
A taxa de subdiagnóstico ultrapassa os 80% das pessoas em países ditos desenvolvidos. Dados alemães, por exemplo, apontam que 30% dos pacientes com estágio final, pré-diálise, passam em consulta sem diagnóstico.
E, para dar o diagnóstico, precisamos apenas de dois exames básicos: dosagem de creatinina no sangue e dosagem de albumina (uma espécie de proteína) na urina.
Em 2021, também tivemos a aprovação nos Estados Unidos da molécula chamada finerenona. Trata-se de um medicamento que bloqueia o hormônio aldosterona que faz com que ocorra inflamação e fibrose nos rins. Bloqueando este hormônio, o rim apresenta uma vida útil mais longa, postergando a necessidade de diálise ou de transplante de rins.
No Brasil, a Anvisa aprovou o uso de dapagliflozina em pessoas com doença renal crônica. Já a finerenona só é liberada para quem tem a disfunção renal e diabetes tipo 2. A empagliflozina ainda aguarda aprovação em nosso país para este objetivo renal.
E as novidades não param por aí. Em 2023, tivemos o anúncio de mais uma molécula com benefícios em pacientes com dano renal crônico. Trata-se de uma velha conhecida contra o diabetes tipo 2 e redução do peso corporal: a semaglutida subcutânea semanal na dose de 1 miligrama (mg).
O estudo FLOW foi interrompido prematuramente devido aos benefícios da molécula em mais de 3 mil pessoas com diabetes tipo 2 e doença renal crônica. O estudo ainda não foi publicado na íntegra e não temos maiores informações, mas a farmacêutica Novo Nordisk divulgou que houve redução de 24% na ocorrência tanto de doenças renais quanto cardíacas nos participantes.
Em suma, em menos de cinco anos, tivemos mais novidades no campo da doença renal crônica da década de 1980 até o ano de 2020.
Boas notícias para o Dia Mundial do Rim 2024!
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