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The Effect of Medical Cooperation in the CKD Patients: 10-Year Multicenter Cohort Study

Onishi, Yasuhiro ; Uchida, Haruhito A ; Maeshima, Yohei ; Okuyama, Yuka ; Otaka, Nozomu ; Ujike, Haruyo ; Tanaka, Keiko ; Takeuchi, Hidemi ; Tsuji, Kenji ; Kitagawa, Masashi ; Tanabe, Katsuyuki ; Morinaga, Hiroshi ; Kinomura, Masaru ; Kitamura, Shinji ; Sugiyama, Hitoshi ; Ota, Kosuke ; Maruyama, Keisuke ; Hiramatsu, Makoto ; Oshiro, Yoshiyuki ; Morioka, Shigeru ; Takiue, Keiichi ; Omori, Kazuyoshi ; Fukushima, Masaki ; Gamou, Naoyuki ; Hirata, Hiroshi ; Sato, Ryosuke ; Makino, Hirofumi ; Wada, Jun

Journal of personalized medicine, 2023-03, Vol.13 (4), p.582 [Periódico revisado por pares]

Switzerland: MDPI AG

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Título:
The Effect of Medical Cooperation in the CKD Patients: 10-Year Multicenter Cohort Study
Autor: Onishi, Yasuhiro ; Uchida, Haruhito A ; Maeshima, Yohei ; Okuyama, Yuka ; Otaka, Nozomu ; Ujike, Haruyo ; Tanaka, Keiko ; Takeuchi, Hidemi ; Tsuji, Kenji ; Kitagawa, Masashi ; Tanabe, Katsuyuki ; Morinaga, Hiroshi ; Kinomura, Masaru ; Kitamura, Shinji ; Sugiyama, Hitoshi ; Ota, Kosuke ; Maruyama, Keisuke ; Hiramatsu, Makoto ; Oshiro, Yoshiyuki ; Morioka, Shigeru ; Takiue, Keiichi ; Omori, Kazuyoshi ; Fukushima, Masaki ; Gamou, Naoyuki ; Hirata, Hiroshi ; Sato, Ryosuke ; Makino, Hirofumi ; Wada, Jun
Assuntos: Analysis ; Blood pressure ; Cholesterol ; chronic kidney disease (CKD) ; Chronic kidney failure ; Cohort analysis ; Collaboration ; Communicable diseases ; Cooperation ; Creatinine ; Diabetes ; End-stage renal disease ; Epidermal growth factor receptors ; Glomerulonephritis ; Health aspects ; Hypertension ; Japan ; Kidney diseases ; medical cooperation ; Medical prognosis ; Mortality ; Nephrology ; OCKD-NET ; patient care team ; Patients ; Physicians ; Precision medicine ; Primary care ; Prognosis ; Proteins ; Uric acid
É parte de: Journal of personalized medicine, 2023-03, Vol.13 (4), p.582
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Contributed equally and shared first authorship.
Descrição: While chronic kidney disease (CKD) is one of the most important contributors to mortality from non-communicable diseases, the number of nephrologists is limited worldwide. Medical cooperation is a system of cooperation between primary care physicians and nephrological institutions, consisting of nephrologists and multidisciplinary care teams. Although it has been reported that multidisciplinary care teams contribute to the prevention of worsening renal functions and cardiovascular events, there are few studies on the effect of a medical cooperation system. We aimed to evaluate the effect of medical cooperation on all-cause mortality and renal prognosis in patients with CKD. One hundred and sixty-eight patients who visited the one hundred and sixty-three clinics and seven general hospitals of Okayama city were recruited between December 2009 and September 2016, and one hundred twenty-three patients were classified into a medical cooperation group. The outcome was defined as the incidence of all-cause mortality, or renal composite outcome (end-stage renal disease or 50% eGFR decline). We evaluated the effects on renal composite outcome and pre-ESRD mortality while incorporating the competing risk for the alternate outcome into a Fine-Gray subdistribution hazard model. The medical cooperation group had more patients with glomerulonephritis (35.0% vs. 2.2%) and less nephrosclerosis (35.0% vs. 64.5%) than the primary care group. Throughout the follow-up period of 5.59 ± 2.78 years, 23 participants (13.7%) died, 41 participants (24.4%) reached 50% decline in eGFR, and 37 participants (22.0%) developed end-stage renal disease (ESRD). All-cause mortality was significantly reduced by medical cooperation (sHR 0.297, 95% CI 0.105-0.835, = 0.021). However, there was a significant association between medical cooperation and CKD progression (sHR 3.069, 95% CI 1.225-7.687, = 0.017). We evaluated mortality and ESRD using a CKD cohort with a long-term observation period and concluded that medical cooperation might be expected to influence the quality of medical care in the patients with CKD.
Editor: Switzerland: MDPI AG
Idioma: Inglês

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The Effect of Medical Cooperation in the CKD Patients: 10-Year Multicenter Cohort Study

Switzerland: MDPI AG

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