Professional paper

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

BOSILJKA DEVČIĆ orcid.org/0000-0001-9011-9483 ; Rijeka University Hospital Centre, Department of Internal Medicine, Division of Nephrology, Dialysis and Kidney Transplantation, Rijeka, Croatia
BOŽIDAR VUJIČIĆ ; Rijeka University Hospital Centre, Department of Internal Medicine, Division of Nephrology, Dialysis and Kidney Transplantation, Rijeka, Croatia
IVAN BUBIĆ ; Rijeka University Hospital Centre, Department of Internal Medicine, Division of Nephrology, Dialysis and Kidney Transplantation, Rijeka, Croatia
LIDIJA ORLIĆ ; Rijeka University Hospital Centre, Department of Internal Medicine, Division of Nephrology, Dialysis and Kidney Transplantation, Rijeka, Croatia
DANIEL VICTOR ŠIMAC ; Rijeka University Hospital Centre, Division of Hematology, Rheumatology and Clinical Immunology, Rijeka, Croatia
STELA ŽIVČIĆ ĆOSIĆ ; Rijeka University Hospital Centre, Department of Internal Medicine, Division of Nephrology, Dialysis and Kidney Transplantation, Rijeka, Croatia
SANJIN RAČKI ; Rijeka University Hospital Centre, Department of Internal Medicine, Division of Nephrology, Dialysis and Kidney Transplantation, Rijeka, Croatia

Abstract

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.

Keywords

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

Hrčak ID:

230090

URI

https://hrcak.srce.hr/230090

Publication date:

5.12.2019.

Article data in other languages: croatian

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