Aim: We conducted a prospective cohort study to evaluate the effectiveness of an integrated care model on delaying chronic kidney disease (CKD) progression in routine clinical practice in rural primary care setting.
Methods: After enrolment, patients with stages 3 to 4 CKD patients from five district hospitals in a northern province of Thailand (400 km from Bangkok) received integrated care comprising hospital multidisciplinary care and home visits by community care teams. Clinical characteristics and biochemical data were collected at baseline and every 3-month interval thereafter for 36 months. The primary outcome was the rate of estimated glomerular filtration rate (eGFR) decline.
Results: Nine hundred and fourteen stage -3 and - 4 CKD patients were enrolled. The mean age of our cohort was 62 years. Diabetic kidney disease (DKD) was the main cause of CKD (53%) whereas hypertension was the most common co-morbidity (92%). The mean rate of eGFR decline was -0.92 mL/min/1.73 m /year. The rate of eGFR decline among patients with DKD was about three times faster than patients without DKD. Patients with higher blood pressure, metabolic acidosis, proteinuria or anaemia had a faster rate of eGFR decline.
Conclusion: This integrated care model at the community level was effective in delaying CKD progression in routine clinical practice situation.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7986192 | PMC |
| http://dx.doi.org/10.1111/nep.13849 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A novel generative multi-task representation learning approach for predicting postoperative complications in cardiac surgery patients.
J Am Med Inform Assoc
December 2024
AI for Health Institute, Washington University in St Louis, St Louis, MO 63130, United States.
Objective: Early detection of surgical complications allows for timely therapy and proactive risk mitigation. Machine learning (ML) can be leveraged to identify and predict patient risks for postoperative complications. We developed and validated the effectiveness of predicting postoperative complications using a novel surgical Variational Autoencoder (surgVAE) that uncovers intrinsic patterns via cross-task and cross-cohort presentation learning.
View Article and Find Full Text PDFChronic kidney disease (CKD) is a common clinical condition with significant health risks for patients and is widely recognised as a major public health concern. Laboratory medicine plays a crucial role in both diagnosing and managing CKD, as diagnosis and staging rely on estimated glomerular filtration rate (GFR) and evaluating albuminuria (or proteinuria). It was evident that the laboratory assessment of CKD in Malaysia is not standardised.
View Article and Find Full Text PDFPerspectives of current and future use of electrical stimulation home-devices from people with spinal cord injuries and healthcare professionals.
Disabil Rehabil
December 2024
Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
Introduction: Electrical stimulation (E-stim) can reduce the impact of complications, like spasticity, bladder dysfunction in people with spinal cord injuries (SCIs), enhancing quality of life and health outcomes. With SCI prevalence high in regional Australia and a shift towards home-based community integrated care, the perspectives of people with SCI and healthcare professionals on current and future use of E-stim home-devices are needed.
Methods: A mixed-methods concurrent triangulation approach was used.
A descriptive summary of the WHO availability assessments of medical abortion medicines in eight African countries.
Reprod Health
December 2024
UNDP‑UNFPA‑UNICEF‑WHO‑World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
Background: The use of medical abortion using either a combination of mifepristone and misoprostol, or misoprostol alone has contributed to increased safety and decreased mortality and morbidity. The availability of quality medical abortion medicines is an essential component in the provision of quality abortion care. Understanding the factors that influence the availability of medical abortion medicines is important to help in-country policymakers, program planners, and providers improve availability and use of medical abortion.
View Article and Find Full Text PDFCollateral damage: the overlooked reproductive health crisis in conflict zones.
Reprod Health
December 2024
The George Institute for Global Health, Imperial College London, London, UK.
Conflict-affected regions face severe reproductive health challenges that disproportionately impact adolescent girls and young women (AGYW) and children, who are especially vulnerable due to the breakdown of healthcare systems and limited access to essential services. AGYW are at heightened risk due to restricted access to family planning, prenatal care, and emergency obstetric services, while children face malnutrition, disease outbreaks, and developmental delays. These challenges have profound long-term consequences for both their physical and psychological well-being.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!