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- Title
Goal attainment and renal outcomes in patients enrolled in the chronic kidney disease care program in Taiwan: a 3-year observational study.
- Authors
Wang, Yi; Lee, Yueh-Ting; Lee, Wen-Chin; Ng, Hwee-Yeong; Wu, Chien-Hsing; Lee, Chien-Te
- Abstract
<bold>Objective: </bold>To analyze the effects of chronic kidney disease (CKD) care programs on clinical outcomes.<bold>Design: </bold>An observational, retrospective study with medical record review.<bold>Setting: </bold>Kaohsiung Chang Gung Memorial Hospital.<bold>Participants: </bold>Patients diagnosed with CKD.<bold>Interventions: </bold>CKD care programs conducted by nephrologists-based team from 2006 to 2013 in our hospital.<bold>Main Outcome Measures: </bold>We set 10 goals with treatment target ranges based on the guidelines suggested by the following organizations: Kidney Disease Improving Global Outcomes (2012) and the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (2003).<bold>Results: </bold>In total, 1486 patients were enrolled. Their average estimated glomerular filtration rate (ml/min/1.73 m2) was 31.9 at baseline and declined to 28.9 in Year 3 (P < 0.001). The all-goals attainment rate increased from 59.4% at baseline to 60.5% in Year 3, with an especially significant improvement for low-density lipoprotein (from 46.8% to 67.0%) and glycated hemoglobin (from 55.0% to 64.0%). Achievement rates decreased for hemoglobin (from 34.2% to 31.0%), calcium (from 94.6% to 92.3%) and phosphate (from 89.9% to 82.5%) between baseline and Year 3. Albuminuria was the least achieved goal (from 23.4% to 24.0%). Subgroup analysis revealed that estimated glomerular filtration rate did not decline in patients who had a good achievement rate, but decreased significantly in patients with a poor achievement rate.<bold>Conclusion: </bold>Enrolment in CKD care programs resulted in a significant improvement in goal attainment by patients. Further, a good achievement rate was associated with better preservation of residual renal function.
- Subjects
TAIWAN; NATIONAL Kidney Foundation Inc.; NEPHROLOGISTS; KIDNEY diseases; CHRONIC diseases; GLOMERULAR filtration rate; GLYCOSYLATED hemoglobin; EDUCATIONAL attainment
- Publication
International Journal for Quality in Health Care, 2019, Vol 31, Issue 4, p252
- ISSN
1353-4505
- Publication type
journal article
- DOI
10.1093/intqhc/mzy161