Nurse Practitioner Care Improves Renal Outcome in Patients with CKD
| العنوان: | Nurse Practitioner Care Improves Renal Outcome in Patients with CKD |
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| المؤلفون: | Marjolijn van Buren, Marc A.G.J. ten Dam, Mieke J. Peeters, Michiel L. Bots, Peter J.G. van de Ven, Gerald Vervoort, Jack F.M. Wetzels, Henk E. Sluiter, Jan A.J.G. van den Brand, Arjan D. van Zuilen, Yvo W. J. Sijpkens, Gerry Ligtenberg, Louis-Jean Vleming, Karin A H Kaasjager, Peter J. Blankestijn |
| المصدر: | Journal of the American Society of Nephrology, 25, 2, pp. 390-8 Journal of the American Society of Nephrology, 25, 390-8 |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Office Visits, Renal function, urologic and male genital diseases, Ambulatory Care Facilities, law.invention, chemistry.chemical_compound, Randomized controlled trial, Clinical Research, law, Physicians, Internal medicine, medicine, Humans, Nurse Practitioners, Renal Insufficiency, Chronic, Vitamin D, Risk factor, Intensive care medicine, Antihypertensive Agents, Aged, Patient Care Team, Aspirin, Creatinine, Proteinuria, business.industry, Hazard ratio, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Metabolic Disorders Radboud Institute for Molecular Life Sciences [Radboudumc 6], Cholesterol, LDL, General Medicine, Middle Aged, Confidence interval, Treatment Outcome, chemistry, Nephrology, Kidney Failure, Chronic, Female, Guideline Adherence, Hydroxymethylglutaryl-CoA Reductase Inhibitors, medicine.symptom, business, Biomarkers, Follow-Up Studies, medicine.drug |
| الوصف: | Item does not contain fulltext Treatment goals for patients with CKD are often unrealized for many reasons, but support by nurse practitioners may improve risk factor levels in these patients. Here, we analyzed renal endpoints of the Multifactorial Approach and Superior Treatment Efficacy in Renal Patients with the Aid of Nurse Practitioners (MASTERPLAN) study after extended follow-up to determine whether strict implementation of current CKD guidelines through the aid of nurse practitioners improves renal outcome. In total, 788 patients with moderate to severe CKD were randomized to receive nurse practitioner support added to physician care (intervention group) or physician care alone (control group). Median follow-up was 5.7 years. Renal outcome was a secondary endpoint of the MASTERPLAN study. We used a composite renal endpoint of death, ESRD, and 50% increase in serum creatinine. Event rates were compared with adjustment for baseline serum creatinine concentration and changes in estimated GFR were determined. During the randomized phase, there were small but significant differences between the groups in BP, proteinuria, LDL cholesterol, and use of aspirin, statins, active vitamin D, and antihypertensive medications, in favor of the intervention group. The intervention reduced the incidence of the composite renal endpoint by 20% (hazard ratio, 0.80; 95% confidence interval, 0.66 to 0.98; P=0.03). In the intervention group, the decrease in estimated GFR was 0.45 ml/min per 1.73 m(2) per year less than in the control group (P=0.01). In conclusion, additional support by nurse practitioners attenuated the decline of kidney function and improved renal outcome in patients with CKD. |
| تدمد: | 1046-6673 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e2dcc13a464e696d3fe87676d748564f https://hdl.handle.net/2066/136411 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e2dcc13a464e696d3fe87676d748564f |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10466673 |
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