TY - JOUR
T1 - Early Chronic Kidney Disease Care Programme delays kidney function deterioration in patients with stage I-IIIa chronic kidney disease
T2 - An observational cohort study in Taiwan
AU - Niu, Shu Fen
AU - Wu, Chung Kuan
AU - Chuang, Nai Chen
AU - Yang, Ya Bei
AU - Chang, Tzu Hao
N1 - Funding Information:
Funding This study was supported by grant from the Ministry of Science and Technology, Taiwan (MOST 109-2314-B-341-003-MY3).
Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/1/19
Y1 - 2021/1/19
N2 - Objectives To investigate the effect of the Early Chronic Kidney Disease (CKD) Care Programme on CKD progression in patients with CKD stage I-IIIa. Design Observational cohort study. Setting Taipei Medical University Research Database from three affiliated hospitals. Participants Adult non-pregnant patients with CKD stage I-IIIa from Taipei Medical University Research Database between 1 January 2012 and 31 August 2017 were recruited. These patients were divided into Early CKD Care Programme participants (case) and non-participants (control). The models were matched by age, sex, estimated glomerular filtration rate and CKD stage with 1:2 propensity score to reduce bias between two groups. Outcome measures The risks of CKD stage I-IIIa progression to IIIb between Early CKD Care Programme participants and non-participants. Results Compared with the control group, the case group demonstrated more comorbidities and higher proportions of hypertension, diabetes mellitus, gout, dyslipidaemia, heart disease and cerebrovascular disease, but had lower risk of progression to CKD stage IIIb before and (HR 0.72; 95% CI 0.61 to 0.85) and after (adjusted HR (aHR) 0.67; 95% CI 0.55 to 0.81) adjustments. Moreover, Kaplan-Meier analysis revealed the cumulative incidence of CKD stage IIIb was significantly lower in the case group than in the control group. Finally, the programme was an independent protective factor against progression to stage IIIb, especially in patients with CKD stage IIIa before (HR 0.72; 95% CI 0.61 to 0.85) and after (aHR 0.67; 95% CI 0.55 to 0.81) adjustments. Conclusions The Early CKD Care Programme is an independent protective factor against progression of early CKD.
AB - Objectives To investigate the effect of the Early Chronic Kidney Disease (CKD) Care Programme on CKD progression in patients with CKD stage I-IIIa. Design Observational cohort study. Setting Taipei Medical University Research Database from three affiliated hospitals. Participants Adult non-pregnant patients with CKD stage I-IIIa from Taipei Medical University Research Database between 1 January 2012 and 31 August 2017 were recruited. These patients were divided into Early CKD Care Programme participants (case) and non-participants (control). The models were matched by age, sex, estimated glomerular filtration rate and CKD stage with 1:2 propensity score to reduce bias between two groups. Outcome measures The risks of CKD stage I-IIIa progression to IIIb between Early CKD Care Programme participants and non-participants. Results Compared with the control group, the case group demonstrated more comorbidities and higher proportions of hypertension, diabetes mellitus, gout, dyslipidaemia, heart disease and cerebrovascular disease, but had lower risk of progression to CKD stage IIIb before and (HR 0.72; 95% CI 0.61 to 0.85) and after (adjusted HR (aHR) 0.67; 95% CI 0.55 to 0.81) adjustments. Moreover, Kaplan-Meier analysis revealed the cumulative incidence of CKD stage IIIb was significantly lower in the case group than in the control group. Finally, the programme was an independent protective factor against progression to stage IIIb, especially in patients with CKD stage IIIa before (HR 0.72; 95% CI 0.61 to 0.85) and after (aHR 0.67; 95% CI 0.55 to 0.81) adjustments. Conclusions The Early CKD Care Programme is an independent protective factor against progression of early CKD.
KW - chronic renal failure
KW - health policy
KW - nephrology
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U2 - 10.1136/bmjopen-2020-041210
DO - 10.1136/bmjopen-2020-041210
M3 - Article
C2 - 33468527
AN - SCOPUS:85100245624
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 1
M1 - e041210
ER -