Prevalence of Chronic Kidney Patients and Factors Affecting Decision-making on Renal Replacement Therapy in the Nephrology Department of Surin Hospital in a Period Between 2014 and 2020

Abstract

Background: To analysis retrospective data from electronic databases to determine prevalence and factors affecting decision-making on renal replacement therapy in end-stage chronic kidney disease patients in CKD clinic , Surin Hospital. The outcomes will be develop the planning treatment and preventive guidelines for slowing kidney degeneration.
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: The results showed that there are no significant differences between the distribution of male and female patients in the data set. The average age of patients were 62 years old, with comorbid diseases, such as hypertension(67.3%), diabetes(41.4%), gout(11.4%), heart disease(4.2%), ischemetic strokes(1%), glomerulonephritis (1 %) and kidney stones (1.1 %).
The prevalence of chronic kidney disease stage 3 was 31 patients, stage 4 was 134 patients and stage 5 was 2,695 patients.The factors associated with renal replacement therapy decisions in chronic kidney disease patients were: (1) Females were 1.1 time more likely to choose dialysis than males, but were not statistically significant (95% CI 0.89-1.41).Increasing age every 3 month had a statistically significant increase on choosing dialysis treatments (95% CI 1.05-1.04).(2)Every 10 units of a decrease of the renal function (eGFR) changes the decision toward a dialysis treatment significantly (95% CI 1.05 - 1.14).
Conclusion: Therefore, knowing the prevalence of chronic kidney disease in the area of the hospital’s responsibility, it is possible to plan patient care slowing down the progression of kidney disease or stabilize the status quo to avoid entering a phase that requires a kidney replacement therapy. Furthermore, the results can be used laying down guidelines for preventing new cases including knowing factors affecting the decision progress on dialysis patients with kidney disease. The information will be used as a guideline for providing patient information material to help patients make faster decisions on their treatment and therefore reducing complications from delays in therapy.
Keywords: Chronic kidney disease; Stage of chronic kidney disease; Renal replacement therapy