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Relationship between compliance with management target values and renal prognosis in multidisciplinary care for

Yoshihiko Imamura1, Yasunori Takahashi2, Takato Takeuchi3

  • 1Department of Nephrology, Nissan Tamagawa Hospital, 4-8-1 Seta Setagaya-ku, Tokyo, 158-0095, Japan. yoshihiko.imamura@gmail.com.

Clinical and Experimental Nephrology
|April 10, 2022
PubMed

Insights

Multidisciplinary care (MDC) improves chronic kidney disease (CKD) management by increasing adherence to treatment targets. This enhanced adherence leads to better renal survival rates and delayed dialysis initiation in CKD patients.

Area of Science:

  • Nephrology
  • Public Health
  • Internal Medicine

Background:

  • Multidisciplinary care (MDC) is recognized as essential for managing chronic kidney disease (CKD).
  • The impact of MDC on achieving guideline-recommended management targets in CKD patients requires further investigation.
  • This study aimed to elucidate the relationship between MDC, target value compliance, and renal prognosis in CKD outpatients.

Purpose of the Study:

  • To assess the effect of multidisciplinary care (MDC) on patient compliance with chronic kidney disease (CKD) management targets.
  • To determine the association between improved target value achievement and renal outcomes, including dialysis initiation and survival rates.

Main Methods:

  • A cohort of 255 pre-dialysis CKD outpatients receiving MDC was analyzed.
  • Achievement rates for blood pressure, hemoglobin, uric acid, LDL cholesterol, and HbA1c were compared pre- and post-MDC (12 months).
  • Renal survival and dialysis initiation rates were evaluated based on categorized achievement rates post-MDC.

Main Results:

  • Overall target achievement rate significantly increased from 62.8% to 69.1% after MDC.
  • Higher achievement rates correlated with lower dialysis initiation rates (e.g., 8.2% for the highest group vs. 72.7% for the lowest).
  • Significantly improved renal survival rates were observed with higher achievement levels.

Conclusions:

  • MDC effectively enhances patient compliance with CKD management target values.
  • Improved adherence to treatment targets through MDC is associated with better renal prognosis and delayed dialysis initiation.
Abstract

Keywords:
Certified kidney disease educatorChronic kidney diseaseClinical practice guidelineHealth literacyMultidisciplinary careRenal replacement therapy

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