The Development Model of Diabetes and Hypertension for to Slow Down the Integrated Kidney Disease Renunakhon Hospital, Renunakhon District, Nakhon Phanom Province

Abstract

Background   : Renunakhon Hospital has established  the Chronic Kidney Disease Clinic in 2016. In terms of service system, no practice model has been applied to the clinic. The patients have to take care of themselves  in using medications,  eating, exercising and smoking. These behaviors increase the risk of rapid decrease in Glomerular filtration rate (GFR).

Objective   : This study was to develop  the practice of taking care of patients with diabetes and hypertension  to slow down kidney disease, Renunakhon  District, Nakhon Phanom province.

Methods   : This study an action research. The samples were 55 patients 65 years old with diabetes and hypertension. The level of eGFR (estimated Glomerular filtration rate )  of patients   was  lower than60 ml./minute in the period of three months. The patients together with their families planned to change health  behaviors and followed  up. The conducted  during October  2016 - March 2018.The research instruments  were CKD staging graph, consumption behavior evaluation checklist, and health behavior interview. The collection comprised three phrases: 1) study the situation of kidney disease in Renunakhon District, 2) outline  of service and try out, and 3) evaluate  the results from the level  of kidney after 6 months and 1 year with the health behavior evaluation. The quantitative data were analyzed by using percentage and mean.

Results   : The development of 55 samples, were found that before development, 24 patients had the kidney in the highest range of 3b (43.6 ⁒), the range of 4, 3a and 5 (41.8⁒), 10.9⁒ and 3.6⁒, respectively. After the development  showed that the samples were in the range of 2, 3a, 3b, 4 and 5 with the number  of patients  of 5, 4, 17, 27 and 2 with of 9.1⁒, 7.3⁒, 30.9⁒, 49.1⁒ and 3.6⁒, respectively. The one-year follow  up results showed that the samples were in the range of 1, 2, 3a, 3b,4 and 5 with the number of patients of 1, 5, 9, 4, 23 and 3 with of 1.8⁒, 9.1⁒, 16.4⁒, 25.5⁒, 41.8⁒ and5.5⁒, respectively. In terms  of behavior,  the patients  with  drug use, protein  and  salty  food consumption were at a high level  (mean score  from  2.6 to 3.4). The patients  who  did exercisewere  at a moderate level  (mean score from 2.4 to 2.8). The patients  who  smoked  were  at a very high level (mean score from3.9 to 4.1).

Conclusion : The study can be effectively  applied  in the people  and patients with a risk of chronic kidney  disease.  The  risk factor  evaluation  of  hyperlipidemia,  blood  pressure  and hypoglycemia  should be applied to make patients realize in taking care of their health.

Keywords   : Chronic Kidney Disease, Risk factors, Diabetes, Hypertension