IMPACT OF MICROVASCULAR DYSFUNCTION ASSOCIATED WITH HYPERTENSION AND DIABETES ON THE PROGRESSION AND ITS SOCIOECONOMIC REPERCUSSIONS OF CHRONIC KIDNEY DISEASE: A 10-YEAR ANALYSIS IN THE STATE OF PARANÁ (2014–2024)

Abstract

Chronic Kidney Disease (CKD) is a growing public health problem, characterized by a progressive nature and a silent course, with significant clinical, social, and economic impact. In the state of Paraná, there has been an increase in incidence, hospitalizations, and healthcare costs, associated with the rising prevalence of systemic arterial hypertension and diabetes mellitus. These comorbidities are key determinants of microvascular dysfunction, a central process in renal deterioration that leads to interstitial fibrosis, glomerulosclerosis, and reduction of the glomerular filtration rate. This study analyzes the correlation between vascular dysfunction and CKD progression based on data from the Brazilian Unified Health System Hospital Information System (2014–2024), the Brazilian Dialysis Census 2023, and KDIGO guidelines (2021–2024). The investigation integrates pathophysiological mechanisms, metabolic and cardiovascular comorbidities, and socioeconomic repercussions within the state public healthcare system. The results highlight the need for policies focused on prevention, early screening — especially microalbuminuria as an initial marker — and strict control of risk factors. It is concluded that strengthening primary healthcare and organizing nephrology care pathways are essential to reduce morbidity, mortality, and associated costs.