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Kidney Week

Abstract: FR-PO328

A Prospective Randomized Controlled Trial of Lifestyle Management for Preventing Respiratory Tract Infection in Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Liu, Meifang, The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
  • Liu, Xusheng, The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
  • Zhang, Lei, The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
Background

Respiratory tract infection (RTI) is a risk factor for progressive loss of kidney function. Lifestyle management has shown potential effect to prevent RTI in chronic kidney disease (CKD) patients. The study assessed the efficacy and safety of lifestyle management in reducing RIT of CKD patients.

Methods

In this prospective randomized controlled trial (RCT), 540 patients with CKD vulnerable to RIT were randomly assigned 1:1 to either lifestyle management group or control group for 48 weeks. Both groups received conventional care according to guideline recommendations, while patients in lifestyle management group additionally accepted health lifestyle management involving life behavior mission, acupoints massage and dietary guidance. The primary outcome was the interval of first occurrence of RIT. Secondary outcomes included the incidence of endpoint events, immunity indices, urinary protein creatinine ratio (PCR), liver and kidney function, cardiovascular events. This study was registered with Chinese Clinical Trials Registry, ChiCTR-IOR-17012654.

Results

540 patients were screened, of whom 262 were randomly assigned: 161 to the lifestyle management group, 161 to the control group (30 patients were excluded) from January 1st, 2016 to December 31st, 2018. 77 (66.4%) patients in the life management group and 78 (67.2%) patients in the control group developed RTI over 48 weeks. Among them, 49 patients (42.2%) and 52 patients (44.8%) had RTI more than twice respectively. The interval of first occurrence of RTI in the life management group was 85.65±84.97 days, which was similar to the control group (84.36±90.63 days). The survival analysis showed that the patients with high frequency of RTI (>3 times within one year before enrollment) in the life management group had a lower risk of RTI than the control group (68 days vs. 65 days) (HR 0.87,95%CI 0.57-1.31). The level of IgA, C4, CH50, CD3CD4, CD3CD4/ CD3CD8 in the life management group was higher than the control group, suggesting that immunity function of the patients was enhanced after lifestyle management. There was no significant difference in endpoint events, liver and kidney function, PCR and other safety indexes between the two groups.

Conclusion

Lifestyle management shows the effect to reduce the prevalence of RTI in CKD and slow CKD progression.

Funding

  • Government Support - Non-U.S.