The effects of a participatory structured group educational program on the development of CKD: a population-based study

Clin Exp Nephrol. 2019 Aug;23(8):1031-1038. doi: 10.1007/s10157-019-01738-1. Epub 2019 Apr 27.

Abstract

Background: The type of lifestyle guidance that is effective for preventing development of chronic kidney disease (CKD) is unknown. Here, we aim to investigate the effects of a participatory structured group education (SGE) program on the development of CKD in a population-based study.

Methods: We retrospectively analyzed 1060 adult special health check-up examinees with CKD. Examinees with an estimated glomerular filtration rate (eGFR) from 50 to 60 mL/min/1.73 m2 and/or proteinuria 1+ were encouraged to attend an SGE program. The SGE program included participatory small group discussions on the attendees' remaining risk factors. The primary outcome of this study was the change in eGFR per year.

Results: The changes in eGFR in examinees who attended the SGE program (n = 209, + 2.9 mL/min/1.73 m2 [95% confidence interval (CI) + 1.9 to + 3.9]) significantly improved compared with control (n = 383, + 1.2 mL/min/1.73 m2 [95% CI + 0.5 to + 1.9], p = 0.006). Attending an SGE program was independently and positively related to the changes in eGFR at 1 year after attendance, after adjusting for classical covariates (β = 1.55 [95% CI 0.37-2.73], p = 0.01). Attending an SGE program was effective for the examinees with a lower eGFR compared with those with only proteinuria.

Conclusions: Our SGE program showed the beneficial effects of preventing the development of CKD, independent of classical factors. The type of SGE program that is more effective for preventing development of CKD should be investigated in a long-term analysis.

Keywords: Chronic kidney disease; Patient education; Special health check-up; Structured group education.

MeSH terms

  • Aged
  • Disease Progression
  • Female
  • Glomerular Filtration Rate
  • Group Processes*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Kidney / physiopathology
  • Male
  • Patient Education as Topic / methods*
  • Patient Participation*
  • Protective Factors
  • Proteinuria / diagnosis
  • Proteinuria / physiopathology
  • Proteinuria / psychology
  • Proteinuria / therapy*
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / prevention & control*
  • Renal Insufficiency, Chronic / psychology
  • Retrospective Studies
  • Risk Factors
  • Risk Reduction Behavior*
  • Time Factors
  • Treatment Outcome