The change of disease stage and clinical outcome of retardation of renal degeneration among patients living with the third and fourth stages of chronic kidney disease in the kidney degeneration clinic of secondary health services

Abstract

Introduction: The mortality rate from chronic kidney disease (CKD) at all ages has increased worldwide. It is possible to eliminate the progression of CKD, as it can be treated with early diagnosis and treatment. Objectives: This research aims to study the changes in the stages of the disease and clinical outcomes in patients with the third and fourth stages of CKD. Patients and Methods: This research is a retrospective analytic study in patients diagnosed with third- and fourth-stage of CKD at the Tha Chang Hospital, Thailand. The research sample consisted of 169 medical records of a small population with a confidence level of 0.95. Research data were collected between October 2019 and March 2021. Data analysis utilized frequency, percentage, paired t test, and Wilcoxon signed-rank test. Results: The results revealed that after one year of attending the clinic, the average systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), hemoglobin A1c (HbA1c), uric acid, high-density lipoprotein (HDL), estimated glomerular filtration rate (eGFR), and urine microalbumin had no differences. However, the average body mass index (BMI), total cholesterol (TC), low-density lipoprotein (LDL), and serum creatinine (sCr) showed statistically significant differences at P<0.05. Most patients with CKD were in stable health conditions and disease stage (87.57%). Conclusion: The third and fourth-stage CKD care model could be achieved by the multidisciplinary care team and requires a strategy that is sustainable in addition to continuous care by involving a family member and caregiver in the community.