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Inpatient educational program delays the need for dialysis in patients with chronic kidney disease stage G5

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Abstract

Background

Inpatient educational programs (IEPs) for patients with chronic kidney disease (CKD) decrease CKD progression. However, patients with end-stage kidney disease who started dialysis during the observation period were excluded from previous studies.

Methods

After adjusting for age, sex, baseline estimated glomerular filtration rate, hemoglobin level, and the presence of diabetes mellitus using 1:1 propensity score matching (caliper width of 0.008) in the groups that did and did not receive an IEP, we compared the time period from the beginning of CKD stage G5 to the start of dialysis and patient characteristics at the start of dialysis.

Results

Prior to matching, 41 patients received an IEP and 260 did not. After propensity score matching, the 41 patients who received an IEP had a longer period from the beginning of stage G5 to the start of dialysis (344 vs. 257 days, P = 0.011), shorter hospitalization period upon the start of dialysis (14 vs. 18 days, P = 0.015) compared with the 41 patients who did not receive an IEP. In addition, the proportion of patients with a planned start of dialysis tended to be higher in the IEP group (95.1 vs. 83.0%, P = 0.077).

Conclusion

An IEP may delay the start of dialysis in patients with end-stage kidney disease, contribute to better preparation of vascular access placement and the smoother start of dialysis.

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Acknowledgements

We gratefully acknowledge Yoshiko Ono, Mie Tagaya and Mami Oohori for collecting the data of this study.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan

    Wei Han Takagi, Kiyomi Osako, Shinji Machida, Kenichiro Koitabashi, Yugo Shibagaki & Tsutomu Sakurada

Authors
  1. Wei Han Takagi
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  2. Kiyomi Osako
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  3. Shinji Machida
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  4. Kenichiro Koitabashi
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  5. Yugo Shibagaki
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  6. Tsutomu Sakurada
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Corresponding author

Correspondence to Tsutomu Sakurada.

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Conflict of interest

All the authors have declared no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee at which the studies were conducted (IRB approval number 4344) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was not necessary because of the retrospective nature of the study. Thus, the need for individual written informed consent was waived. However, a declaration of data was published on the website (https://www.marianna-u.ac.jp/houjin/disclosure/clinical-research/marianna/file/ichiran.pdf. Accessed June 16, 2020). The study information was published on the internet, and thus, patients could use the Division of Graduate Student Affairs and Research promotion websites to opt-out of the study if they did not want their data used for research purposes.

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Takagi, W.H., Osako, K., Machida, S. et al. Inpatient educational program delays the need for dialysis in patients with chronic kidney disease stage G5. Clin Exp Nephrol 25, 166–172 (2021). https://doi.org/10.1007/s10157-020-01979-5

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  • DOI: https://doi.org/10.1007/s10157-020-01979-5

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