Kidney Week

Abstract: FR-PO943

Pilot Feasibility of Coordinated Multidisciplinary Model Can Improve Management and Outcomes of Patients With CKD Under University Healthcare in Thailand

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

• Rattanasompattikul, Manoch, Golden Jubilee Medical Center, Faculty of Medicine Siriraj Hospital, Phutthamonthon, Nakhon Pathom, Thailand

Manoch Rattanasompattikul,

• Rongkiettechakorn, Nuttawut, Golden Jubilee Medical Center, Faculty of Medicine Siriraj Hospital, Phutthamonthon, Nakhon Pathom, Thailand

Nuttawut Rongkiettechakorn,

• Jampong, Malinporn, Golden Jubilee Medical Center, Faculty of Medicine Siriraj Hospital, Phutthamonthon, Nakhon Pathom, Thailand

Malinporn Jampong,

• Masoodi, Sumana, Mahidol University Faculty of Medical Technology Salaya Campus, Salaya, Nakhon Pathom, Thailand

Sumana Masoodi,

• Promkan, Moltira, Mahidol University Faculty of Medical Technology Salaya Campus, Salaya, Nakhon Pathom, Thailand

Moltira Promkan,

• Supokawej, Aungkura, Mahidol University Faculty of Medical Technology Salaya Campus, Salaya, Nakhon Pathom, Thailand

Aungkura Supokawej,

Background

Thailand's renal care system is an evolving educational healthcare system. The limitation of the data system for chronic kidney disease (CKD) patients is the lack of the generation of data that can be analyzed. An appropriate kidney care model for individual hospitals allows for better and safer care at lower cost, enhancement of public health, and patient empowerment is needed. A learning CKD care system should aim to collect, accumulate and analyze data, interpret results, deliver a tailored message, and take action to change practices.

Methods

Adult non-pregnant participants 18 years of age or older with diagnosed CKD stages G3 toward G5ND (non-dialysis) were enrolled in the CKD clinic of Golden Jubilee Medical Center between April 2019 and March 2021. A robust and efficacious CKD clinic is always underpinned by applicable workflow (Figure 1).

Results

There were 454 patients identified as requiring multidisciplinary care (65% male; 35% female; mean age 72), and the majority of these were in stages 3a, 3b, and 4 CKD (34%, 31%, and 19%). Compliance with established practice guidelines prior to clinic restructuring and post-intervention were 30% vs. 31% for ASA use; 22% vs. 35% for vitamin D supplement; 44% vs. 48% for ACEi/ARB use; 78% vs. 95% for statin use.The age and gender adjustment identified the odds ratio (OR) of eGFR < 30 ml/min/1.73m² as an independent risk factor for serum bicarbonate below 22 mEq/L was 5.02; 2.49–10.13;P<0.001.

Conclusion

Through the established database and data analysis, an integrated care system should improve clinical outcomes and achieve the most cost effective care. Awareness of the process is important for clinicians who are aiming to advocate for effective changes in prevention or improvement of outcomes in CKD clinics.

Figure 1.

Funding

• Government Support – Non-U.S.