初级保健诊所肾内科联络诊所试点项目的临床结果:一项回顾性观察研究。

Q3 Nursing
Malaysian Family Physician Pub Date : 2025-06-13 eCollection Date: 2025-01-01 DOI:10.51866/oa.762
Tiong Lim Low, Ismail Rohayah, Bavanandan Sunita, Abdul Wahab Mohamad Zaimi, Wan Mohamad Hazlina Wan
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引用次数: 0

摘要

导读:Klinik Kesihatan senul于2019年启动了肾病联络诊所试点项目,将肾病服务纳入初级保健。该项目由初级保健医生管理,定期提供肾病专家意见,旨在加强早期干预,减少三级保健负担。方法:回顾性分析2019 - 2021年入组患者的临床结局。包括慢性肾脏疾病G3期或G4/G5期住院转诊下降的患者和持续性蛋白尿患者。未随访、死亡或转移到其他诊所的患者被排除在外。数据分析包括描述性统计、卡方检验、Fisher精确检验和McNemar检验。结果:共纳入73例患者。1年后,45例(61.6%)继续接受初级保健,28例(38.4%)需要三级转诊,主要是肾脏替代治疗准备。在初级保健患者中,71.1%(32/45)维持或减缓了肾小球滤过率的估计下降。结论:本研究表明,在初级保健机构中,肾脏学联络诊所在稳定肾功能和改善代谢参数方面是可行的。研究结果强调了共享医疗模式在资源有限环境下的潜力。然而,在确保充足的人力资源和改善获得肾保护药物方面仍然存在挑战。有必要进行更大规模的长期研究,以验证这种综合方法的长期效益和更广泛的适用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical outcomes of the pilot project Nephrology Liaison Clinic in a primary care clinic: A retrospective observational study.

Introduction: The pilot project Nephrology Liaison Clinic, initiated in 2019 at Klinik Kesihatan Sentul, integrates nephrology services into primary care. Managed by primary care physicians with periodic nephrologist input, this project aims to enhance early intervention and reduce tertiary care burdens.

Methods: In this retrospective study, the clinical outcomes of patients enrolled from 2019 to 2021 were analysed. Patients with chronic kidney disease stage G3 or stage G4/G5 declining hospital referral and those with persistent proteinuria were included. Patients who were lost to follow-up, deceased or transferred to other clinics were excluded. Data analysis included descriptive statistics, the chi-square test, Fisher's exact test and McNemar test.

Results: A total of 73 patients were included. After 1 year, 45 (61.6%) remained under primary care, while 28 (38.4%) required tertiary referral, predominantly for renal replacement therapy preparation. Among the primary care patients, 71.1% (32/45) either had maintained or slowed estimated glomerular filtration rate decline. Ten patients had their HbA1c improved from >8% to <8% (p = 0.002), and 13 more patients were initiated on sodium-glucose cotransporter-2 inhibitors compared to baseline (p < 0.001).

Conclusion: This study demonstrates the feasibility of nephrology liaison clinics in stabilising renal function and improving metabolic parameters within primary care settings. The findings highlight the potential of shared-care models in resource-limited settings. However, challenges remain in ensuring adequate human resources and improving access to renoprotective medications. Larger-scale, longterm studies are warranted to validate the long-term benefits and wider applicability of this integrated approach.

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来源期刊
Malaysian Family Physician
Malaysian Family Physician Medicine-Family Practice
CiteScore
1.20
自引率
0.00%
发文量
41
审稿时长
24 weeks
期刊介绍: The Malaysian Family Physician is the official journal of the Academy of Family Physicians of Malaysia. It is published three times a year. Circulation: The journal is distributed free of charge to all members of the Academy of Family Physicians of Malaysia. Complimentary copies are also sent to other organizations that are members of the World Organization of Family Doctors (WONCA).
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