Prospective study of 2151 patients with chronic kidney disease under conservative treatment with multidisciplinary care in the Vale do Paraíba, SP

Luciano, Eduardo de Paiva; Luconi, Paulo Sérgio; Sesso, Ricardo; Melaragno, Cláudio S.; Abreu, Patrícia Ferreira; Reis, Sandra Ferreira Stanisck; Furtado, Rejane Maria Spindola; Ruivo, Gilson Fernandes

doi:10.5935/0101-2800.20120003

Cited by 18 publications

(25 citation statements)

References 22 publications

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“…By confirming that the CKD in adults is secondary to hypertension and diabetes, this study follows results of national and international literature (11,15) and reinforces the need for health professionals to be vigilant for early identification of markers of renal function damage on groups considered to be at clinic risk, such as hypertensive and diabetic people (4,15) , and also on those with sociodemographic risk factors for CKD such as low education level and low per capita (3) .income. In addition, the population should be warned that it is an asymptomatic disease in its early stages.…”

Section: Discussionsupporting

confidence: 79%

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Letramento funcional em saúde e conhecimento de doentes renais em tratamento pré-dialítico

et al. 2017

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Objective: to analyze the functional health literacy (FHL), i.e., understanding and knowledge about chronic renal disease of 60 patients in pre-dialytic treatment. Method: this is a cross-sectional study. FHL was measured by B-TOFHLA; and the knowledge, by questionnaire. Pearson correlation and Chi-square tests were carried out as well as linear regression models. Results: all respondents presented inadequate FHL, and most showed insuffi cient knowledge about the disease and treatment. Low schooling was a predictive factor for worst FHL scores. Insuffi cient knowledge was related to age and compromised cognition. Conclusion: although association between predictive variables has not been found, limited capability to obtain and use health-related information and insuffi cient knowledge about their own condition and treatment can contribute to worse outcomes for CKD. Appropriate intervention strategies are necessary to deal with limited FHL and also greater knowledge and ability of professionals to deal with the matter.

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Section: Discussionsupporting

confidence: 79%

“…Such variables are commonly described in the literature as factors that may influence on the prognosis and management of CKD (3,11,15) . For this study, the biochemical parameters related to the last appointment of the patient were considered.…”

Section: Study Protocolmentioning

confidence: 99%

Letramento funcional em saúde e conhecimento de doentes renais em tratamento pré-dialítico

et al. 2017

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“…The excellent CKD clinic might also prevent a decline in eGFR, and this result was correlated to related studies [19, 20]. However, renal events including 50% decline in eGFR and ESRD did not significantly differ between the two groups.…”

Section: Discussionsupporting

confidence: 82%

Cardiovascular and Renal Outcomes in an Excellent Chronic Kidney Disease Clinic Compared with an Outpatient Clinic in a Primary Care Setting: A Retrospective Cohort Study

et al. 2019

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Background: Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality. In standard care, the physician attempts to control all known risk factors, but treatment goals are achieved with difficulty. Assistance by a multidisciplinary care team may improve outcomes. Objective: To compare the cardiovascular and renal endpoints between patients with CKD receiving care from excellent CKD and outpatient clinics. Methods: A retrospective cohort study was conducted in a primary care setting in Thailand. Patients with CKD stages 3 and 4 in excellent CKD (n = 96) and outpatient clinics (n = 192) were matched in a 1: 2 ratio with the propensity score. We collected data from electronic medical records concerning the incidences of primary composite outcomes including rapid renal progression, end-stage renal disease, myocardial infarction, congestive heart failure, stroke, and mortality. Multidisciplinary team care in the excellent CKD clinic consisted of physician, nurse, pharmacist, dietitian, physical therapist, and applied Thai traditional physician. The outpatient clinic consisted of physician care only. Results: Subjects’ mean age was 64.54 ± 10.96 years, and 52.1% were female. During an average 49.63 ± 8.36 months of follow-up, 74 events occurred including 35 (47.30%) patients who experienced renal events, 29 (39.19%) who experienced cardiovascular events, and 10 (13.51%) who experienced loss of life. The Kaplan-Meier curve indicated a higher percentage of subjects without primary composite outcomes in the excellent CKD clinic than those in the outpatient clinic (66.85%; 95% CI 0.48–0.80 vs. 44.71%; 95% CI 0.29–0.60; p = 0.005). From multivariate analysis, the excellent CKD clinic group had a 64% lower risk for primary composite outcomes compared with those in the outpatient clinic (adjusted HR 0.36; 95% CI 0.18–0.74; p = 0.005). Conclusion: A multidisciplinary care system can reduce composition outcomes including cardiovascular and renal outcomes for the growing CKD population. The optimal outcomes arise from the medical personnel’s teamwork, not from one physician alone.

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“…Regarding this public, CKD itself can be cited as a possible cause, since the individuals affected by it constitute a population at high risk for cognitive decline due to the use of polypharmacy and the more frequent comorbidities (DM and SAH) (18) . The mean time evaluated in conservative treatment was 4.62 years which shows superior time when compared to other units that have the same ambulatory service (19) . In addition to regional issues, social, political and cultural aspects may be involved with this difference, however, the growing expansion of ambulatory care, in the country, must be considered (20) .…”

Section: Discussionmentioning

confidence: 81%

Quality of life of elderly people with chronic kidney disease in conservative treatment

Pereira

Batista²,

Meira

et al. 2017

Rev. Bras. Enferm.

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Objective:To describe the quality of life (QOL) of elderly people with Chronic Kidney Disease (CKD) in conservative treatment, correlating it with sociodemographic and health-related aspects. Method: This is a quantitative, cross-sectional, and descriptive study that used: a previously validated instrument for data collection; the WHOQOL-BREF and WHOQOL-OLD QOL scales; and the MiniMental State Examination. Results: Thirty-fi ve elderly people (54.30% females), with mean age of 68.26 years, took part in the study. They reported, on average, 3.70 comorbidities and 5.60 complications related to CKD. Regarding QOL, the "psychological" domain (54.40±16.29) and the "death and dying" facet (37.32±23.79) were considered the most damaged ones; the most strengthened were "social relationships" (70.36±18.32) and "intimacy" (66.61±16.80). A positive correlation was verifi ed between comorbidities and complications (p = 0.015), and an inverse correlation between the number of complications and QOL (p = 0.004). Conclusion: These results, if considered during the care planning, may help improving the quality of the care provided for elderly people with CKD. Descriptors: Renal Insuffi ciency, Chronic; Elderly People; Quality of Life; Chronic Disease; Demographic Aging. RESUMO Objetivo: Descrever a qualidade de vida (QV) de idosos com Doença Renal Crônica (DRC) em tratamento conservador, correlacionando-a com aspectos sociodemográfi cos e de saúde. Método: Pesquisa quantitativa, transversal e descritiva que utilizou: um instrumento pré-validado para coleta dos dados de caracterização; as escalas de QV WHOQOL-BREF e WHOQOL-OLD; e o Mini Exame do Estado Mental. Resultados: Participaram 35 idosos (54,30% mulheres) com média de 68,26 anos. Referiram em média 3,70 comorbidades e 5,60 complicações relacionadas à DRC. Na QV, demonstraram-se mais prejudicados o domínio "psicológico" (54,40±16,29) e a faceta "morte e morrer" (37,32±23,79); e mais fortalecidos o domínio "relações sociais" (70,36±18,32) e a faceta "intimidade" (66,61±16,80). Verifi cou-se correlação positiva entre número de comorbidades e de complicações (p = 0,015), e correlação inversa entre número de complicações e a QV (p = 0,004). Conclusão: Se levados em consideração durante o planejamento de cuidados, tais resultados podem auxiliar na melhoria da qualidade da assistência ao idoso com DRC. Descritores: Insufi ciência Renal Crônica; Idoso; Qualidade de Vida; Doença Crônica; Envelhecimento da População. RESUMEN Objetivo: Describir la calidad de vida (CV) de ancianos con Enfermedad Renal Crónica (ERC) en tratamiento conservador, correlacionando con aspectos sociodemográfi cos y de salud. Método: Investigación cuantitativa, transversal y descriptiva que ha utilizado: un instrumento pre-validado para la recolección de los datos de caracterización; las escalas de QV WHOQOL-BREF y WHOQOL-OLD; y el Mini Examen del Estado Mental. Resultados: Participaron 35 ancianos (54,30% mujeres) con edad media de 68,26 años. En promedio se midieron 3,70 comorbilidades y 5,60 comp...

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Prospective study of 2151 patients with chronic kidney disease under conservative treatment with multidisciplinary care in the Vale do Paraíba, SP

Cited by 18 publications

References 22 publications

Letramento funcional em saúde e conhecimento de doentes renais em tratamento pré-dialítico

Letramento funcional em saúde e conhecimento de doentes renais em tratamento pré-dialítico

Cardiovascular and Renal Outcomes in an Excellent Chronic Kidney Disease Clinic Compared with an Outpatient Clinic in a Primary Care Setting: A Retrospective Cohort Study

Quality of life of elderly people with chronic kidney disease in conservative treatment

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