Effect of Pre-ESRD Care on CKD Progression in Taiwan: A Retrospective Analysis

 

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https://storage.unitedwebnetwork.com/files/1099/6f7f47187376d0a01131527be45362f4.pdf
Effect of Pre-ESRD Care on CKD Progression in Taiwan: A Retrospective Analysis

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Yi Ling
Chang
Yi Ling Chang assisichang@gmail.com Chi Mei Medical Center Nursing Department Tainan Taiwan *
Hui-Hsuan Huang cmh7347@mail.chimei.org.tw Chi Mei Medical Center Nursing Department Tainan Taiwan -
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The global prevalence of chronic kidney disease (CKD) continues to rise, posing significant burdens on healthcare systems and economies. Since 2006, Taiwan has implemented the “Pre-End-Stage Renal Disease (Pre-ESRD) Care and Education Program,” targeting patients in CKD stages 3b to 5. This multidisciplinary program, involving nephrologists, nurse educators, and dietitians, provides regular biochemical monitoring, health education, and nutritional counseling, aiming to slow renal function decline and reduce dialysis prevalence. 

This retrospective study analyzed data from patients newly enrolled in the Pre-ESRD care program at a single medical center between January and December 2023. Patients received health education every three months and nutritional counseling every six months over a one-year care period. After excluding those who died or had irregular follow-ups, 85 patients with complete blood test data were included. To ensure consistency, nurse educators followed standardized procedures during education sessions. 

Among the 85 participants, 51 were male (60.0%) and 34 female (40.0%), with the majority aged over 65 years (69.4%). The most common education level was elementary school (22.4%). Changes in estimated glomerular filtration rate (eGFR) showed that 43.5% of patients experienced a decline between +10 to -5 mL/min/1.73m², 12.9% declined between -5 to -10, and 3.5% declined more than -10. Comorbidities included diabetes (60.0%), hypertension (83.5%), and hyperlipidemia (61.2%), with 43.5% of patients having all three conditions. 

The Pre-ESRD care program helps slow renal function deterioration. However, under the current system, nurse educators face limitations due to outpatient time constraints and patient volume, making it difficult to improve education quality. It is recommended that the National Health Insurance Administration and hospitals collaborate to promote remote education using

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