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Following up of Stage 5 Chronic Kidney Disease Patients Managed with Non-dialytic Treatment

อำนวยพร แดงสีบัว; Amnuayporn Daengsibua; อัจฉราวรรณ โตภาคงาม; Acharawan Topark-ngarm; สัจจะ ตติยานุพันธ์วงศ์; Sajja Tatiyanupanwong; จุฬาภรณ์ ลิมวัฒนานนท์; Chulaporn Limwattananon;
Date: 2558-06
Abstract
The first treatment option for end stage renal disease patients is dialysis. However, some patients select non-dialysis treatment (NDT). Currently, data on clinical outcome of this treatment modality is limited. Therefore, a retrospective cohort study was performed to evaluate clinical outcomes of chronic kidney disease (CKD) stage 5 patients managed with NDT, including survival, factors affecting survival, and hospitalization. The data was reviewed from the first date approaching to stage 5 (glomerular filtra-tion rate < 15 ml/min/ 1.73 m2) for at least 2 years, until death, or until the end of the study. A total of 72 patients who fulfilled the eligibility criteria were included to the study. The mean age was 65.4 years old. The most common cause of CKD was diabetes mellitus (n = 35, 48.6%). The most common co-morbidity was hypertension (n = 54, 38.6%). The most common reason for selecting NDT was lacking of a caregiver. The median overall survival was 26.1 months. One-year and two-year survival rates were 80.0% and 59.0%, respectively. There were 307 occasions of unplanned visit, and 115 of these were related to renal causes (37.5%). A total of 56 (77.8%) patients were hospitalized on 179 occasions. One hundred and two (57.0%) of these were due to renal causes. This study demonstrates that the survival time of NDT patients was approximately 2 years. There were high numbers of unplanned visits and hospitalization among these patients. Therefore, NDT modality should be considered as a choice only for patients who are contraindicated or not eligible for dialysis, or who would not be beneficial from dialysis.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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