Tadsaneewan Gantagad. Incidence and predictors of progression in chronic kidney disease. Doctoral Degree(Nursing). Mahidol University. Mahidol University Library and Knowledge Center. : Mahidol University, 2017.
Incidence and predictors of progression in chronic kidney disease
Abstract:
Chronic kidney disease usually causes a decline in kidney function and results end stage renal disease. The objective of the study consisted of determining the incidence of faster kidney disease progression and determining factors affecting on kidney disease progression among patients with chronic kidney disease. The samples in this study included 2,185 patients' medical records, and 360 patients with chronic kidney disease who visited outpatient clinic in eight hospitals located in one of the health area and Bangkok Metropolitan administration area. The results showed the incidence of faster kidney disease progression was 13.12 per 100 persons-years. The predicting factors of faster kidney disease progression were CKD knowledge 0.54 (95% CI; 0.43 - 0.72, p < .01), self-management ability 0.79 (95% CI; 0.71-0.88, p < .01), self-management support 0.12 (95% CI; 0.06-0.25, p < .01). The paths of factors affecting kidney disease progression included CKD knowledge (β = 0.11, p < .001), self-management support were significant (β = 0.03, p < .001), path from the CKD knowledge to kidney disease progression were significant (β = -0.19, p < 0.05), path from self-management to kidney disease progression were significant (β = -0.15, p < .001). The results of the testing revealed Chi-square (χ2) = 2.06, df = 1, p = 0.15, RMSEA = 0.05, NFI = 0.98. The study result imply that health care provider including nurse may enhance the success of delaying the kidney function decline by providing CKD knowledge and self-management support. In addition, human resource allocation is necessary for health service system in both of quantity and quality of provider.