Theeranut Ampornpan, Methakanjanasak Nonglak, Surit Pattama, Srina Junto, Sirivongs Dhavee, Adisuksodsai Doangjai, Lertsinudom Sunee, Sawanyawisuth Kittisak
Department of Adult Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, 40002 Thailand.
Research and Training Center for Enhancing Quality of Life of Working Age People, Khon Kaen University, Khon Kaen, Thailand.
Int J Med Sci. 2021 Mar 3;18(9):1975-1979. doi: 10.7150/ijms.53189. eCollection 2021.
: Several randomized controlled trials have examined the benefits of multidisciplinary CKD care on estimated glomerular filtration rate (eGFR). But, the results are inconclusive. This study aimed to evaluate whether or not multidisciplinary CKD care was beneficial in terms of CKD progression. : This is a randomized controlled trial and conducted at community hospital, Thailand. The inclusion criteria were patients with age of 18 years or older and diagnosed with up to stage 3b CKD based on the KDIGO guidelines. Eligible patients divided into two groups: intervention and control group. The intervention group received a type of multidisciplinary treatment, while patients in the control group received the standard treatment administered at the outpatient clinic. The primary outcome was eGFR outcomes at three months after enrollment. : During the study period, there were 334 patients who met the study criteria. Eligible patients were divided into two groups: intervention (166 patients; 49.70%) and control (168 patients; 50.30%). There were three outcomes that differed significantly between the two groups at 3 months: mean difference of eGFR from baseline, proportion of patients with eGFR decline greater than 4 mL/min/1.73 m, and difference in CKD stage from baseline. A significantly higher percentage of patients in the intervention group experienced CKD improvement by one stage (24.10% vs 5.95%), and a significantly lower percentage experienced decline by one stage (8.43% vs 35.12%) than in the control group. : Slower renal progression in patients with up to stage 3b CKD was shown in patients who were treated by a multidisciplinary approach.
多项随机对照试验研究了多学科慢性肾脏病（CKD）护理对估算肾小球滤过率（eGFR）的益处。但结果尚无定论。本研究旨在评估多学科CKD护理在CKD进展方面是否有益。这是一项在泰国社区医院进行的随机对照试验。纳入标准为年龄在18岁及以上、根据KDIGO指南诊断为3b期及以下CKD的患者。符合条件的患者分为两组：干预组和对照组。干预组接受一种多学科治疗，而对照组患者接受门诊标准治疗。主要结局是入组后三个月时的eGFR结果。在研究期间，有334名患者符合研究标准。符合条件的患者分为两组：干预组（166例患者；49.70%）和对照组（168例患者；50.30%）。两组在3个月时存在三个显著差异的结局：eGFR相对于基线的平均差异、eGFR下降大于4 mL/min/1.73 m²的患者比例以及CKD分期相对于基线的差异。干预组中CKD改善一个阶段的患者百分比显著更高（24.10%对5.95%），且经历下降一个阶段的患者百分比显著更低（8.43%对35.12%），均低于对照组。多学科治疗的3b期及以下CKD患者显示出肾脏进展较慢。
