The impact of self-management support on the progression of chronic kidney disease - A prospective randomized controlled trial

Sue Hsien Chen, Yun Fang Tsai, Chiao Yin Sun, I. Wen Wu, Chin Chan Lee, Mai Szu Wu

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Background. Chronic kidney disease (CKD) is a public health problem worldwide. Multidisciplinary intervention helps improve outcomes for CKD patients. We conducted an open-label, randomized controlled trial to examine the impact of self-management support (SMS) in the outcome of late-stage CKD patients.Methods. Incidental CKD (Stages III-V) patients were randomized into self-management support (SMS) and non-SMS groups and followed up for 12 months. SMS comprised health information, patient education, telephone-based support and the aid of a support group. The primary end points were absolute estimated glomerular filtration rate (eGFR) alteration and number of hospitalization events. The secondary end points were an eGFR decrease of up to 50%, end-stage renal disease (ESRD) demanding renal replacement therapy (RRT), all-cause mortality or a composite secondary end point.Results. The study included 54 patients; 27 patients were randomized into an SMS group and the same number into a non-SMS group. The absolute eGFR at the end of the study was significantly higher in SMS patients than in the non-SMS group (29.11 ± 20.61 versus 15.72 ± 10.67 mL/min; P <0.05). There were fewer hospitalization events for SMS patients than for non-SMS patients [5 (18.50%) versus 12 (44.47%); P <0.05]. One patient (3.7%) in the SMS group and nine (33.3%) in the non-SMS group had an eGFR reduction of >50% (P <0.05). However, survival analysis of the composite secondary end points of ESRD that required RRT and all-cause mortality revealed no differences between the two groups.Conclusions. Our randomized study suggests that a standardized SMS program may play a significant role in reducing CKD progression and morbidity of late-stage CKD patients.

Original languageEnglish
Pages (from-to)3560-3566
Number of pages7
JournalNephrology Dialysis Transplantation
Volume26
Issue number11
DOIs
Publication statusPublished - Nov 2011
Externally publishedYes

Fingerprint

Self Care
Chronic Renal Insufficiency
Self-Help Groups
Randomized Controlled Trials
Glomerular Filtration Rate
Renal Replacement Therapy
Chronic Kidney Failure
Mortality
Patient Education
Survival Analysis
Telephone
Disease Progression
Hospitalization
Public Health
Morbidity
Health

Keywords

  • chronic kidney diseases
  • end-stage renal disease
  • self-management
  • self-management support

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

The impact of self-management support on the progression of chronic kidney disease - A prospective randomized controlled trial. / Chen, Sue Hsien; Tsai, Yun Fang; Sun, Chiao Yin; Wu, I. Wen; Lee, Chin Chan; Wu, Mai Szu.

In: Nephrology Dialysis Transplantation, Vol. 26, No. 11, 11.2011, p. 3560-3566.

Research output: Contribution to journalArticle

Chen, Sue Hsien ; Tsai, Yun Fang ; Sun, Chiao Yin ; Wu, I. Wen ; Lee, Chin Chan ; Wu, Mai Szu. / The impact of self-management support on the progression of chronic kidney disease - A prospective randomized controlled trial. In: Nephrology Dialysis Transplantation. 2011 ; Vol. 26, No. 11. pp. 3560-3566.
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