Stručni rad

STRUCTURED PREDIALYSIS EDUCATION PROGRAM – 10-YEAR EXPERIENCE AT RIJEKA UNIVERSITY HOSPITAL CENTRE

BOSILJKA DEVČIĆ orcid.org/0000-0001-9011-9483 ; Klinički bolnički centar Rijeka, Klinika za internu medicinu, 1Zavod za nefrologiju, dijalizu i transplantaciju bubrega
BOŽIDAR VUJIČIĆ ; Klinički bolnički centar Rijeka, Klinika za internu medicinu, 1Zavod za nefrologiju, dijalizu i transplantaciju bubrega
IVAN BUBIĆ ; Klinički bolnički centar Rijeka, Klinika za internu medicinu, 1Zavod za nefrologiju, dijalizu i transplantaciju bubrega
LIDIJA ORLIĆ ; Klinički bolnički centar Rijeka, Klinika za internu medicinu, 1Zavod za nefrologiju, dijalizu i transplantaciju bubrega
DANIEL VICTOR ŠIMAC ; Klinički bolnički centar Rijeka, Klinika za internu medicinu, Zavod za hematologiju, reumatologiju i kliničku imunologiju, Rijeka, Hrvatska
STELA ŽIVČIĆ ĆOSIĆ ; Klinički bolnički centar Rijeka, Klinika za internu medicinu, 1Zavod za nefrologiju, dijalizu i transplantaciju bubrega
SANJIN RAČKI ; Klinički bolnički centar Rijeka, Klinika za internu medicinu, 1Zavod za nefrologiju, dijalizu i transplantaciju bubrega

Sažetak

Global assessment of the prevalence chronic kidney disease (CKD) ranges from 11% to 13% with 50% of the elderly showing signs of kidney dysfunction. The aim of the study was to determine whether structured predialysis program affects the choice of treatment, method and timing of treatment initiation in all patients, with special reference to older adult patients. Retrospective analysis included 634 patients with CKD treated at the Nephrology Department, Rijeka University Hospital Centre from January 1, 2008 till the end of 2017. Patients were divided into three groups based on predialysis education or renal replacement therapy. Furthermore, as a separate group, we analyzed patients having presented to nephrology for the fi rst time or started some of the alternative methods at age ≥65 years. In the group of senior adults, we analyzed data on 319 patients. We divided patients into three groups and followed the time line defi ned in Event 1-3 expressed in years, from the fi rst nephrologic review until the end of 2017. The analysis showed no statistically signifi cant gender difference (p>0.670). The χ2-test showed statistical signifi cance for diabetes mellitus type 2 compared to other PKD causes (p<0.001). In group 1, 52.38% of 147 patients started some of the follow-up methods and 47.61% of patients were treated conservatively or were preparing for dialysis. The patients in this group statistically signifi cantly preferred PD compared to the other two groups (p<0.05). The ANOVA and LSD test in older adults showed a statistically signifi cant difference in the timeline in group 1 as compared to the other two groups (p<0.001). Gehan’s Wilcoxon test (p=0.00043) and Cox’s F-test (p=0.00001) in survival analysis showed a statistically signifi cant difference in survival between the groups (p<0.05). Survival analysis revealed that preparation or treatment after ten years of survival curve, there was no difference between the groups regardless of the choice. The study opened up the question of continuation with greater emphasis on planned, extended diagnosis after the fi rst patient referral, especially at an older age that might have interpreted survival more clearly.

Ključne riječi

hemodialysis; education of patients; peritoneal dialysis; survival; transplantation

Hrčak ID:

230090

URI

https://hrcak.srce.hr/230090

Datum izdavanja:

5.12.2019.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.050 *