Prevalence of Chronic Kidney Patients and Factors Affecting Decision-making of Renal Replacement Therapy in the Kidney Disease Clinic, Surin Hospital During the Year 2014 and 2020
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Abstract
Background: To determine the prevalence of chronic kidney disease patients and factors affecting decision-making on renal replacement therapy in end-stage chronic kidney disease patients in Kidney Clinic Surin Hospital. These make it to plan care for chronic kidney disease patients in the future.
Objective: Prevalence of chronic kidney disease patients in the Kidney Clinic Surin Hospital during the year 2014-2020 and factors affecting decision-making on renal replacement therapy in end-stage chronic kidney disease patients.
Methods: A retrospective descriptive study by analyzing data from an electronic database of chronic kidney disease patients in the nephrology clinic, Surin Hospital. To study the prevalence of chronic kidney disease patients at various stages and factors affecting decision-making on renal replacement therapy in end-stage chronic kidney disease patients in the Surin Hospital nephrology clinic during 2014-2020 who are older than or equal to 18 years. The exclusion criteria included patients with incomplete data, i.e. no serum creatinine or eGFR, and patients diagnosed with acute kidney injury or acute renal failure.
Results: A total of 2860 patients in the study, calculated using the CKD-EPI equation.There were 31 patients with stage 3 chronic renal failure, 134 patients with stage 4 and 2695 stage 5 patients who received servicesat the Surin Hospital nephrology clinicduring the year 2014-2020. The basic characteristics of chronic renal failure patients had an average age of 62 years, divided into 47.3% male and 52.7% female gender, 26.3% lived in Muang district, who with comorbidities such as diabetes41.4%, hypertension 67.3%, gout 11.4%, heart disease 4.2%, ischemic stroke 1%, Glomerulonephritis 1% and kidney stones 1.1%.In this study, the factors affecting the decision to replace dialysis in chronic kidney disease patients were females 1.1 times more likely to choose a dialysis than males, but were not statistically significant (95%CI 0.89-1.41), age increasing every 3 months statistically significant effect on dialysis decisions (95%CI 1.03-1.04). Every 10unit change in renal function had an effect on dialysis decisions in patients with chronic kidney diseasestatistically significant (95%CI 1.05-1.14).Other blood results, such as hematocrit, blood urea nitrogen, sodium, potassium, bicarbonate, calcium, phosphorus, albumin did not affect the patient's decision on dialysis. The caregiver factor did not directly affect the decision on dialysis in chronic kidney disease patients.
Conclusion: The prevalence of chronic kidney disease is known in the area of responsibility; it is possible to plan patient care to slow the progression of kidney disease andnot to enter end stage renal disease which that requires renal replacement therapy and laying out guidelines for preventing new cases. Including knowing the factors affecting the decision on dialysis patients with kidney disease. The information will be used as a guideline for providing patient information to help patients make faster treatment decisions forreduce complications from delays a dialysis decision.
Keywords: Chronic kidney disease, Stage of chronic kidney disease, Renal replacement therapy
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