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Kidney Week

Abstract: PO2400

The Association Between the Adherence of Self-Management and Prognosis of Non-Dialysis CKD Stages 3-5 Patients

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Zhang, Min, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
  • Lei, Nuo, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
  • Zhang, Xianlong, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
  • Fu, Lizhe, Chronic Disease Management Outpatient, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
  • Tang, Fang, Chronic Disease Management Outpatient, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
  • Liu, Xusheng, Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou, Guangdong, China
  • Wu, Yifan, Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine), Guangzhou, Guangdong, China
Background

Self-management plays a very important role in the prognosis of patients with CKD. However, there is a lack of evidence-based results to support this. This study aimed to evaluate the association between the adherence of self-management and prognosis of non-dialysis CKD stages 3-5 patients.

Methods

Data including basic information, laboratory test results, oral drugs, time of endpoint events were retrospectively collected. Patients were divided into good or poor adherence according to whether they participated in self-management education on time every month. Endpoints were the initiation of renal replacement therapy and death.

Results

785 patients were included in this study. 111 and 674 patients were considered to have good and poor adherence, respectively. 12 and 162 endpoint events occurred in the good and poor adherence groups. Propensity score matching was performed. After 1:2 matching, the outcomes of 315 patients were analyzed(109 : 206 ). Univariate Cox regression was performed to screen variables with P < 0.05, then we further performed Cox proportional hazards regression with three adjusted models. The results of the 3 models all showed that the good adherence of self-management was an independent factor associated with reduced risk of incident endpoints(HR95%CI: Model 1: 0.47(0.25, 0.89); Model 2: 0.31(0.15, 0.64); Model 3: 0.26(0.12, 0.60)). The Kaplan-Meier analysis demonstrated that the cumulative incidence of endpoint events in the good adherence group was significantly lower than that in the poor adherence group (log-rank test, P < 0.05).

Conclusion

This study suggests that good adherence with self-management could effectively reduce the incidence of endpoint events in CKD stages 3-5 patients