The Situation of Medical Treatment for Chronic Kidney Disease in Hospital, Nakhon Ratchasima Province

Abstract

This retrospective study aimed to survey the situation of medical treatment for chronic kidney disease (CKD) in 33 hospitals at Nakhon Ratchasima province. Data were retrieved from electronic database (Health data center) between 2018 – 2019  fiscal year.   Three key performance indicator (KPI) of renal service plan were used as indicators of this study, ie (1) risk factor control (2) rational use of drug for prevent progression of renal failure (3) complication of chronic kidney disease. Descriptive statistic were used.

Mostly, CKD patients with risk factor were uncontrolled in hospitals.  Most of patients did not receive RAAS blockade to slow progression of CKD.  Patients who received two RAAS blocked were still found with decreased tendency. Statins were used in patients with CKD more than 60% for prevention of cardiovascular progression. NSAIDs were slightly used in patients with CKD.  In addition, metformin were used in patients with CKD stage 4 with decreased tendency. Principally, laboratory examination for follow up system were not done and no report. In 2020, 66.93% of patients with CKD stage 3 and 4 with eGFR decline not more than 5 ml/min/1.73m²per year were found. Mostly, stage of patients with CKD were remained stable at 74.44% and 75.96%, (stage 3 and stage 4) respectively. Clinical practice for CKD patients should be corresponding with clinical practice guideline and ministry of public health indicators in order to provide accuracy, and safety for patients. Intentionally, rational use of drug for patients with CKD should be concerned.  Pharmaceutical care should be participated and integrated into treatment of patients with CKD to decreased drug related problems.