Impact of Home-Based Rehabilitation on Renal Prognosis in Patients with Chronic Kidney Disease.

IF 1.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Nippon Medical School Pub Date : 2024-01-01 DOI:10.1272/jnms.JNMS.2024_91-508

Ayako Ikenouchi, Yukinao Sakai, Shouhei Wada, Yorito Yanagida, Tetsuya Kashiwagi, Masato Iwabu

{"title":"Impact of Home-Based Rehabilitation on Renal Prognosis in Patients with Chronic Kidney Disease.","authors":"Ayako Ikenouchi, Yukinao Sakai, Shouhei Wada, Yorito Yanagida, Tetsuya Kashiwagi, Masato Iwabu","doi":"10.1272/jnms.JNMS.2024_91-508","DOIUrl":null,"url":null,"abstract":"Background: The increasing prevalence of chronic kidney disease (CKD) requires effective preventive measures, particularly due to an aging population. This study aimed to assess the effectiveness of home visit rehabilitation in preventing renal function decline among patients with CKD.Method: In this retrospective study, patients with non-dialysis CKD undergoing home visit rehabilitation were compared with those receiving outpatient care at the Nippon Medical School Hospital between August 2017 and August 2023. Patients' backgrounds were matched using propensity scores derived from a logistic regression model. The primary endpoint was the annual change in the estimated glomerular filtration rate (eGFR), and the secondary endpoint was the annual change in blood parameters (Δblood urea nitrogen, Δcreatinine, Δtotal protein, Δalbumin, ΔC-reactive protein, Δhemoglobin, and Δhematocrit). Furthermore, the incidence of clinical outcomes, including mortality, hospitalization rate, and dialysis initiation rate, were analyzed within the additional 1-year observation period.Results: Overall, 128 patients (64 matched pairs) were analyzed. After a mean follow-up period of 12.7 ± 4.6 months, there was no significant difference in the eGFR between both groups (40.1 ± 13.7 vs. 37.8 ± 13.8 mL/min/1.73 m2, p = 0.36), but the annual decline in eGFR (%/year) was significantly lower in the rehabilitation group (-1.1 ± 29.8% vs. -11.8 ± 27.7%/year, p = 0.037). The annual change in the level of each blood test parameter and clinical outcomes were not significantly different between the two groups.Conclusion: Home-based rehabilitation interventions may mitigate the progression of renal impairment in patients with CKD.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"91 5","pages":"439-445"},"PeriodicalIF":1.2000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nippon Medical School","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1272/jnms.JNMS.2024_91-508","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The increasing prevalence of chronic kidney disease (CKD) requires effective preventive measures, particularly due to an aging population. This study aimed to assess the effectiveness of home visit rehabilitation in preventing renal function decline among patients with CKD.

Method: In this retrospective study, patients with non-dialysis CKD undergoing home visit rehabilitation were compared with those receiving outpatient care at the Nippon Medical School Hospital between August 2017 and August 2023. Patients' backgrounds were matched using propensity scores derived from a logistic regression model. The primary endpoint was the annual change in the estimated glomerular filtration rate (eGFR), and the secondary endpoint was the annual change in blood parameters (Δblood urea nitrogen, Δcreatinine, Δtotal protein, Δalbumin, ΔC-reactive protein, Δhemoglobin, and Δhematocrit). Furthermore, the incidence of clinical outcomes, including mortality, hospitalization rate, and dialysis initiation rate, were analyzed within the additional 1-year observation period.

Results: Overall, 128 patients (64 matched pairs) were analyzed. After a mean follow-up period of 12.7 ± 4.6 months, there was no significant difference in the eGFR between both groups (40.1 ± 13.7 vs. 37.8 ± 13.8 mL/min/1.73 m², p = 0.36), but the annual decline in eGFR (%/year) was significantly lower in the rehabilitation group (-1.1 ± 29.8% vs. -11.8 ± 27.7%/year, p = 0.037). The annual change in the level of each blood test parameter and clinical outcomes were not significantly different between the two groups.

Conclusion: Home-based rehabilitation interventions may mitigate the progression of renal impairment in patients with CKD.

查看原文本刊更多论文

居家康复对慢性肾病患者肾脏预后的影响

背景：慢性肾脏病（CKD）的发病率越来越高，需要采取有效的预防措施，特别是由于人口老龄化。本研究旨在评估家访康复在预防 CKD 患者肾功能衰退方面的效果：在这项回顾性研究中，在2017年8月至2023年8月期间，接受家访康复治疗的非透析型慢性肾脏病患者与在日本医科大学附属医院接受门诊治疗的患者进行了比较。采用逻辑回归模型得出的倾向分数对患者的背景进行匹配。主要终点是估计肾小球滤过率（eGFR）的年度变化，次要终点是血液参数（Δ血尿素氮、Δ肌酐、Δ总蛋白、Δ白蛋白、ΔC反应蛋白、Δ血红蛋白和Δ血细胞比容）的年度变化。此外，在额外的 1 年观察期内，还分析了临床结果的发生率，包括死亡率、住院率和开始透析率：共分析了 128 名患者（64 对配对患者）。在平均 12.7 ± 4.6 个月的随访期后，两组患者的 eGFR 没有显著差异（40.1 ± 13.7 vs. 37.8 ± 13.8 mL/min/1.73 m2，p = 0.36），但康复组患者的 eGFR 年下降率（%/年）显著低于对照组（-1.1 ± 29.8% vs. -11.8 ± 27.7%/年，p = 0.037）。两组患者血液检测各项参数的年变化水平和临床结果无明显差异：结论：家庭康复干预可减轻慢性肾脏病患者肾功能损害的进展。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Nippon Medical School MEDICINE, GENERAL & INTERNAL-

CiteScore

1.80

自引率

10.00%

发文量

118

期刊介绍： The international effort to understand, treat and control disease involve clinicians and researchers from many medical and biological science disciplines. The Journal of Nippon Medical School (JNMS) is the official journal of the Medical Association of Nippon Medical School and is dedicated to furthering international exchange of medical science experience and opinion. It provides an international forum for researchers in the fields of bascic and clinical medicine to introduce, discuss and exchange thier novel achievements in biomedical science and a platform for the worldwide dissemination and steering of biomedical knowledge for the benefit of human health and welfare. Properly reasoned discussions disciplined by appropriate references to existing bodies of knowledge or aimed at motivating the creation of such knowledge is the aim of the journal.