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Title Prevalence, risk factors and prevention of Chronic Kidney Disease in the Communities of Northeast Taiwan |
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Type Oral Presentation |
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Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
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Topic Chronic Kidney Disease: Epidemiology, Outcomes, Special Populations |
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Main Author I-WEN WU1 2 3 |
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Presenting Author I-WEN WU1 2 3 |
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Co-Author Jeng-Rong Hsu1 2 3 Chiao-Yin Sun1 2 3 Yuen-Chan Chen Yu-Chiau Shyu2 Chin-Chan Lee1 2 3 |
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Department / Institution / Country Nephrology / Chang Gung Memorial Hospital, Keelung / Taiwan (台灣)1 Community Medicine Research Center / Chang Gung Memorial Hospital, Keelung / Taiwan (台灣)2 College of Medicine / Chang Gung University / Taiwan (台灣)3 |
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Abstract Content: Introduction, Method, Result, Conclusion Introduction:The prevalence of CKD ranges from 11-14% worldwide, causing significant health burden because of progression to ESRD and increased risk of cardiovascular disease and mortality. Multidisciplinary care for moderate and advanced CKD patients has been implemented as standard practice for CKD management; however, prevention of CKD to incentivize approach of health or at-risk subjects for early intervention remains to be established in the community. Methods:We conducted periodic community activities for screening of CKD and delivered interactive multidisciplinary education to promote health knowledge of CKD in 29 Districts of Northeast Taiwan. We investigated the personal and family characteristics of participants by using questionnaires, SF-36, biochemistry, immunity and metabolomics markers in these communities. We assessed the effectiveness of delivery of multidisciplinary education on the reduction of risk of CKD in the community. Results:5072 participants were enrolled from communities of Northeast Taiwan. The mean age was 57.6 ± 13.2 years, mean eGFR was 94.8 ± 26.2mL/min/1.73 m2and 38.5% were men. Diabetes was present in 11% of all participants. The prevalence of CKD was 19%. The low health knowledge score (<2.5), presence of metabolic syndrome, diabetes, hypertension, hepatitis C infection and education level below junior high school were independent risk factors for CKD. Increase of knowledge score by delivering multidisciplinary education was associated with reduced risk of CKD (OR: 5.4 to 2.5; from low knowledge score to high knowledge score). Pathway analysis identified obesity, metabolic syndrome and inflammation as significant mediator of the multidisciplinary education to reduce the risk of CKD. Conclusions:Appropriate multidisciplinary education was associated with reduced risk of CKD in the community. Especially, knowledge to combat the obesity, metabolic syndrome and inflammation are key factors to ameliorate the risk of CKD in these patients. The findings of present study may provide model of community care in areas with similar socioeconomic characteristics. |