An inpatient educational program for chronic kidney disease

Chronic kidney disease (CKD) is a significant health problem in Japan, and prevention programs to slow disease progression are necessary. In this study, we evaluated the effectiveness of a 1-week inpatient education program, delivered during the predialysis stage of CKD, in slowing the deterioration in renal function over the subsequent 2 years, and identified factors influencing the program's effectiveness.

We retrospectively evaluated the estimated glomerular filtration rate (eGFR) of 105 consecutive patients who completed the program, at the following time points: 6 months prior to program initiation, at program initiation and, at 6, 12, 18, and 24 months after the program. To identify factors predictive of program effectiveness, we classified patients into a Responder and Non-responder group.

In comparison with the rate of deterioration in renal function (mL/min/1.73 m²/year) before admission, the rate slowed at 6, 12, 18 and 24 months after discharge (all p < 0.01). A urinary protein (UP) level <0.5 g/gCr and CKD stages 4-5 were predictive of a slowing of CKD progression after the education program.

Although the effectiveness of our program declined over time, it did produce an overall slowing in the rate of renal function deterioration over the 2-year period of observation after discharge. This slowing of CKD progression was more pronounced in patients with low UP levels, indicating that education programs should be considered while these levels are still low. Furthermore, the program still offers benefits to patients with CKD stages 4-5.