Clinical Outcomes Among High-Risk Primary Care Patients With Diabetic Kidney Disease
Methodological Challenges and Results From the STOP-DKD Study
Datos Bibliográficos
| ID | 9103346 |
|---|---|
| Autores | Hayden B Bosworth (0000-0001-6188-9825, Duke University, autor de correspondencia), Uptal D Patel (0000-0002-6905-6649, Division of Nephrology, Duke University School of Medicine, Durham, NC), Allison A Lewinski (0000-0002-1356-1857, Duke University, autor de correspondencia), Clemontina A Davenport (0000-0003-3875-7466, Department of Biostatistics and Bioinformatics, Durham, NC, autor de correspondencia), Jane Pendergast (0000-0001-5169-8371, Department of Biostatistics and Bioinformatics, Durham, NC, autor de correspondencia), Megan Oakes (0000-0002-4619-1784, Duke University, autor de correspondencia), Matthew J Crowley (0000-0002-6205-4536, Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, Durham, NC), Leah L Zullig (0000-0002-6638-409X, Duke University, autor de correspondencia), Sejal Patel (0000-0002-2985-1189, Division of General Internal Medicine, Duke University School of Medicine, Durham, NC), Jivan Moaddeb (Duke University), Julie Miller (0000-0001-5270-8463, Duke University), Julie J Miller (0000-0002-1288-593X, Duke University, autor de correspondencia), Shauna Malone (Duke University, autor de correspondencia), Huiman X Barnhart (0000-0003-0988-3439, autor de correspondencia), Huiman Barnhart (Department of Biostatistics and Bioinformatics, Durham, NC), Clarissa J Diamantidis (0000-0001-8212-6288, Duke University, autor de correspondencia) |
| Año | 2024 |
| Volumen | 62 |
| Número | 10 |
| Páginas | 660-666 |
| Fecha de publicación | 2024-10-01 |
| Peer Reviewed | Sí |
| Open Access | No |
| Tipo | ARTICLE |
| Revista | Medical Care (JOURNAL) |
| Identificadores de la revista | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Editorial | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000002043 |
| PMID | 39038105 |
| OpenAlex | W4400877263 |
| Idioma | EN |
| Referencias citadas | 20 |
BACKGROUND/OBJECTIVE: Slowing the progression of diabetic kidney disease (DKD) is critical. We conducted a randomized controlled trial to target risk factors for DKD progression. METHODS: We evaluated the effect of a pharmacist-led intervention focused on supporting healthy behaviors, medication management, and self-monitoring on decline in estimated glomerular filtration rate (eGFR) for 36 months compared with an educational control. RESULTS: We randomized 138 individuals to the intervention group and 143 to control. At baseline, mean (SD) eGFR was 80.7 (21.7) mL/min/1.73m 2 , 56% of participants had chronic kidney disease and a history of uncontrolled hypertension with a baseline SBP of 134.3 mm Hg. The mean (SD) decline in eGFR by cystatin C from baseline to 36 months was 5.0 (19.6) and 5.9 (18.6) mL/min/1.73m 2 for the control and intervention groups, respectively, with no significant between-group difference ( P =0.75). CONCLUSIONS: We did not observe a significant difference in clinical outcomes by study arm. However, we showed that individuals with DKD will engage in a pharmacist-led intervention. The potential explanations for a lack of change in DKD risk factors can be attributed to 5 broad issues, challenges: (1) associated with enrolling patients with low eGFR and poor BP control; (2) implementing the intervention; (3) limited duration during which to observe any clinical benefit from the intervention; (4) potential co-intervention or contamination; and (5) low statistical power
Clinical trial · Diabetes mellitus · Disease · Intervention (counseling) · Kidney disease · Physical therapy · Randomized controlled trial · Renal function · Diabetes Management and Education · Internal Medicine · Medication Adherence and Compliance · Medicine · Nursing · Pharmaceutical Practices and Patient Outcomes
| Velocidad de citación | historical |
|---|---|
| Altamente citado | No |