Effectiveness of Pre-renal Replacement Therapy Program on Chronic Kidney Disease Progression in Community Hospital, Central Thailand.
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Abstract
Background: Chronic kidney disease (CKD) is a growing health burden, particularly as it progresses to end-stage renal disease (ESRD). In Thailand, early intervention is vital. This study evaluated the impact of a pre-renal replacement therapy nutritional program on disease progression, blood pressure, and treatment decision-making among CKD patients.
Methods: A retrospective cohort study was conducted using medical records of CKD outpatients at Tha Luang Hospital, Lopburi Province, between January 1, 2020, and September 15, 2024. Patients aged ≥18 years who received nutritional counseling were included. Data on estimated glomerular filtration rate (eGFR) and blood pressure were collected at 3-, 6-, and 12-month pre-intervention, and at 3-, 6-, and 12-month post-intervention. Multivariable regression analysis adjusted for age, sex, CKD stage, comorbidities, medications, and lifestyle factors. Treatment decision changes regarding RRT were also analyzed.
Results: After adjustment, the rate of eGFR decline decreased post-intervention (from −3.765 ± 0.355 mL/min/1.73 m² per 3 months). Changes in systolic and diastolic blood pressure were not statistically significant. Notably, 6.5% of patients altered their treatment decision to opt for RRT after receiving program information.
Conclusion: The pre-kidney replacement therapy nutritional program contributed to slowing CKD progression and supported informed treatment decisions. Incorporating such programs into routine CKD care is recommended.
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