综合团体教育对降低慢性肾脏病患者体重、尿酸水平和利尿剂使用的疗效：一项回顾性研究。
Efficacy of comprehensive group-based education in lowering body weight, uric acid levels, and diuretic use in patients with chronic kidney disease: a retrospective study.
机构信息
Department of Nursing, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
Department of Nephrology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.
出版信息
BMC Nephrol. 2023 Sep 14;24(1):272. doi: 10.1186/s12882-023-03293-0.
BACKGROUND
Patient education for the management of chronic kidney disease (CKD) is attracting attention. Therefore, this study aimed to analyze changes in body weight, uric acid, and estimated-glomerular filtration rate (eGFR) in patients with CKD after a group-based education during admission.
METHODS
Overall, 157 patients with CKD, who were discharged from the nephrology department of our hospital between January 2015 and October 2019, received group-based education or individual-based education by nurses at admission. Deltas of body weight, uric acid, and eGFR, 6 months from baseline, were compared between group- and individual-based education using the Wilcoxon rank sum test.
RESULTS
In total, 60 patients receiving group-based education (G group, n =35) or individual-based education (I group, n =25) during admission were included in this retrospective study. The patient characteristics at baseline were as follows: age mean, 72 ± SD 9; 16 females and 44 males; body weight, 62 ± 17 kg; eGFR median, 21 (IQR: 14, 29) mL/min/1.73 m; UA, 7 (6.1, 7.5) mg/dL; and estimated intake of salt 6.9 (6.2, 8.4) g/day. Delta eGFR (mL/min/1.73 m) was -1 (-3, 3) for G group and -1 (-2.5, 2) for I group (p = 0.8039). Delta body weight (kg) was -0.4 (-1.6, 0) for G group and 0 (-0.45, 0.95) for I group (p = 0.0597). Delta uric acid (mg/dL) was -1.1 (-1.6, 0.1) for G group and -0.2 (-1.1, 0.5) for I group (p = 0.0567). In patients with higher sodium intake (≥ 117.4 mEq/day), delta body weight was significantly lower in the group-based education group than in the individual-based education group (p = 0.0398).
CONCLUSIONS
A comprehensive group-based education in patients with CKD may effectively suppress body weight and uric acid in 6 months along with less frequent diuretic use.
背景
患者的慢性肾脏病（CKD）管理教育正受到关注。因此，本研究旨在分析入院时接受基于小组的教育后，CKD 患者的体重、尿酸和估算肾小球滤过率（eGFR）的变化。
方法
本研究共纳入 2015 年 1 月至 2019 年 10 月期间从我院肾病科出院的 157 例 CKD 患者，入院时护士对患者进行基于小组或基于个体的教育。使用 Wilcoxon 秩和检验比较组间和个体间教育后 6 个月时体重、尿酸和 eGFR 的变化。
结果
共纳入 60 例患者，他们在入院时接受基于小组的教育（G 组，n=35）或基于个体的教育（I 组，n=25）。入组时患者的特征如下：年龄平均为 72 ± 9 岁；女性 16 例，男性 44 例；体重 62 ± 17kg；eGFR 中位数为 21（IQR：14，29）mL/min/1.73m；UA 为 7（6.1，7.5）mg/dL；估计盐摄入量为 6.9（6.2，8.4）g/天。G 组的 eGFR 变化（mL/min/1.73m）为-1（-3，3），I 组为-1（-2.5，2）（p=0.8039）。G 组体重变化（kg）为-0.4（-1.6，0），I 组为 0（-0.45，0.95）（p=0.0597）。G 组尿酸变化（mg/dL）为-1.1（-1.6，0.1），I 组为-0.2（-1.1，0.5）（p=0.0567）。在钠摄入量较高（≥117.4mEq/天）的患者中，基于小组的教育组的体重变化明显低于基于个体的教育组（p=0.0398）。
结论
CKD 患者的综合小组教育可能会在 6 个月内有效抑制体重和尿酸，同时减少利尿剂的使用。
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