Multifactorial intervention with nurse practitioners does not change cardiovascular outcomes in patients with chronic kidney disease
| العنوان: | Multifactorial intervention with nurse practitioners does not change cardiovascular outcomes in patients with chronic kidney disease |
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| المؤلفون: | Peter J.G. van de Ven, Marc A.G.J. ten Dam, Gerry Ligtenberg, Yvo W. J. Sijpkens, Jack F.M. Wetzels, Ingeborg van der Tweel, Gerald Vervoort, Peter J. Blankestijn, Arjan D. van Zuilen, Henk E. Sluiter, Arzu Dulger, Marjolijn van Buren, Louis-Jean Vleming, Michiel L. Bots, Karin A H Kaasjager |
| المصدر: | Kidney International. Supplement, 82, 6, pp. 710-7 Kidney International. Supplement, 82, 710-7 |
| سنة النشر: | 2012 |
| مصطلحات موضوعية: | Male, Nephrology, Time Factors, Myocardial Infarction, Kidney, Severity of Illness Index, law.invention, Randomized controlled trial, Risk Factors, law, Preventive Health Services, Medicine, Stroke, Netherlands, Renal disorder [IGMD 9], Hazard ratio, blood pressure, Middle Aged, Combined Modality Therapy, cardiovascular event, Treatment Outcome, Cardiovascular Diseases, Practice Guidelines as Topic, Disease Progression, Female, Guideline Adherence, Glomerular Filtration Rate, medicine.medical_specialty, Health aging / healthy living [IGMD 5], epidemiology and outcome, Renal function, Motor Activity, Risk Assessment, Article, Internal medicine, Weight Loss, Humans, Nurse Practitioners, Renal Insufficiency, Chronic, Risk factor, Intensive care medicine, Aged, Proportional Hazards Models, business.industry, Cardiovascular Agents, medicine.disease, Blood pressure, Linear Models, Kidney Failure, Chronic, Smoking Cessation, business, Risk Reduction Behavior, chronic kidney disease, Kidney disease |
| الوصف: | Item does not contain fulltext Strict implementation of guidelines directed at multiple targets reduces vascular risk in diabetic patients. Whether this also applies to patients with chronic kidney disease (CKD) is uncertain. To evaluate this, the MASTERPLAN Study randomized 788 patients with CKD (estimated GFR 20-70 ml/min) to receive additional intensive nurse practitioner support (the intervention group) or nephrologist care (the control group). The primary end point was a composite of myocardial infarction, stroke, or cardiovascular death. During a mean follow-up of 4.62 years, modest but significant decreases were found for blood pressure, LDL cholesterol, anemia, proteinuria along with the increased use of active vitamin D or analogs, aspirin and statins in the intervention group compared to the controls. No differences were found in the rate of smoking cessation, weight reduction, sodium excretion, physical activity, or glycemic control. Intensive control did not reduce the rate of the composite end point (21.3/1000 person-years in the intervention group compared to 23.8/1000 person-years in the controls (hazard ratio 0.90)). No differences were found in the secondary outcomes of vascular interventions, all-cause mortality or end-stage renal disease. Thus, the addition of intensive support by nurse practitioner care in patients with CKD improved some risk factor levels, but did not significantly reduce the rate of the primary or secondary end points. |
| تدمد: | 2157-1724 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bce0e11f02cbf498974239391c7a3a90 https://hdl.handle.net/2066/108753 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....bce0e11f02cbf498974239391c7a3a90 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21571724 |
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