Department of Nephrology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Department of Nephrology, Sasebo City General Hospital, 9-3 Hirase-cho, Sasebo, Nagasaki 857-8511, Japan.
Nutrients. 2020 Sep 4;12(9):2703. doi: 10.3390/nu12092703.
Educational hospitalization of patients with chronic kidney disease (CKD) may slow the progression of renal dysfunction. However, the educational aspect that is more effective has not been identified to date. In this study, patients with CKD were evaluated for gustatory threshold for salty taste and received augmented salt reduction guidance under educational hospitalization at Nagasaki University Hospital from October 2016. In total, 277 eligible patients were enrolled and hospitalized from 2012 to 2019 (mean age of 69.2 years; men comprised 62.1%). We compared 141 patients (Group A) who were educated in the hospital after October 2016 and 136 patients (Group B) who received standard education in the hospital before October 2016. The changes in the estimated glomerular filtration rate (ΔeGFR) after hospitalization and dialysis induction rate within one year after hospitalization were evaluated. The ΔeGFR was significantly improved in Group A compared to Group B (A: 1.05 mL/min/1.73 m/month, B: 0.55 mL/min/1.73 m/month; = 0.02). The dialysis induction rate was significantly lower in Group A than in Group B (A: 8.5%, B: 15.5%; = 0.001). These trends were also observed by multivariate analyses. In conclusion, educational hospitalization with enhanced salt reduction guidance may reduce the risk of end-stage renal disease.
教育住院治疗慢性肾脏病(CKD)患者可能会减缓肾功能障碍的进展。然而,迄今为止,尚未确定哪种教育方法更有效。在这项研究中,我们评估了 CKD 患者的咸味味觉阈值,并在 2016 年 10 月起在长崎大学医院对患者进行强化盐减量指导的教育住院治疗。共有 277 名符合条件的患者于 2012 年至 2019 年期间入组并住院治疗(平均年龄 69.2 岁;男性占 62.1%)。我们比较了 2016 年 10 月后在医院接受教育的 141 名患者(A 组)和 2016 年 10 月前在医院接受标准教育的 136 名患者(B 组)。评估了住院后估算肾小球滤过率(eGFR)的变化和住院后一年内开始透析的比例。与 B 组相比,A 组住院后 eGFR 的改善更明显(A:1.05 mL/min/1.73 m/month,B:0.55 mL/min/1.73 m/month;=0.02)。与 B 组相比,A 组开始透析的比例也显著降低(A:8.5%,B:15.5%;=0.001)。多变量分析也观察到了这些趋势。总之,强化盐减量指导的教育住院治疗可能降低终末期肾病的风险。