Efficiency of the Program for Slowing Progression of Chronic Kidney Disease in Stage 3 CKD Patients of CKD Clinic: U-Thong Hospital Suphan Buri

Abstract

Objective: The purpose was to study the program for decreasing renal progression in stage 3 chronic kidney disease with a multidisciplinary team in a newly organized CKD-clinic since 2015.

Methods: The study design was two-group pretest–posttest design with follow-up for 2 years. The control group was patients in the preceding chronic disease clinic (NCD-clinic) and the intervention group was patients in the chronic kidney disease clinic (CKD-clinic). Paired t test and independent paired t test were used of statistical analysis.

Results: The group of patients in CKD-clinic could actually slow down renal progression. The pre-study and post-study of estimated GFR (eGFR) rates in 2 years did not differ at 43.02 ± 6.88 ml/min/1.73 m2 and 43.29 ± 10.47 ml/min /1.73 m2. The rate of eGFR changed in 2nd year of NCD-clinic was -3.61 ± 7.52 ml/min/1.73 m2 and one of CKD-clinic was -0.14 ± 7.42 ml/min/1.73 m2, eGFR of CKD-clinic was less decreased than NCD-clinic with statistical significance p < .001. The kidney progression in the intervention group was better than in the control group, percentages of patients with rate of eGFR decreased less than 5 ml/min/1.73 m2 of CKD-clinic and NCD-clinic in 1st and 2nd year were 77.4% (155) and 81.9% (145); 76.3% (155) and 57.1% (166) respectively.

Conclusion: The new CKD-clinic with multidisciplinary team can provide knowledge to make cognitive behavioral therapy into knowledge of self-care and self-control. The patients in CKD-clinic more efficiently slow down the renal progression than the control group.