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Received for publication: 26.7.10; Accepted in revised form: 14.6.11
Nephrol Dial Transplant (2011) 26: 3560–3566
doi: 10.1093/ndt/gfr047
Advance Access publication 17 March 2011
The impact of self-management support on the progression of chronic
kidney disease—a prospective randomized controlled trial
Sue-Hsien Chen1,2, Yun-Fang Tsai1,2, Chiao-Yin Sun3,4, I-Wen Wu3,4, Chin-Chan Lee3,4 and
Mai-Szu Wu3,4
1
Department of Nursing, Chang Gung Memorial Hospital, Keelung, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang
Gung University, Taoyuan, Taiwan, 2Chang Gung University, Taoyuan, Taiwan, School of Nursing, Taoyuan, Taiwan, 3Division of
Nephrology, Chang Gung Memorial Hospital at Keelung, Taoyuan, Taiwan and 4Chang Gung University, Taoyuan, Taiwan, School of
Medicine, Taoyuan, Taiwan
Correspondence and offprint requests to: Mai-Szu Wu; E-mail:
Abstract
Background. Chronic kidney disease (CKD) is a public
health problem worldwide. Multidisciplinary intervention
helps improve outcomes for CKD patients. We conducted
an open-label, randomized controlled trial to examine the
impact of self-management support (SMS) in the outcome
of late-stage CKD patients.
Methods. Incidental CKD (Stages III–V) patients were
randomized into self-management support (SMS) and
non-SMS groups and followed up for 12 months. SMS
comprised health information, patient education,
telephone-based support and the aid of a support group.
The primary end points were absolute estimated glomerular
filtration rate (eGFR) alteration and number of hospitalization
The Author 2011. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
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N. Tsuboi et al.
Impact of self-management support on progression of CKD
Keywords: chronic kidney diseases; end-stage renal disease;
self-management; self-management support
Introduction
share responsibility for treatment decisions with patients
[12, 13].
Active patient participation is paramount in the effective
management of CKD, which is a long-lasting, frustrating and
often progressive disease. Progression may be partly delayed
with self-management [14]. However, the long-lasting nature of the disease, along with its progression, makes CKD
self-management difficult. Furthermore, self-management is
not easy to evaluate, especially in the long-term. The specific
nature of CKD self-management highlights the importance
of self-management support (SMS) for this progressive disease. SMS refers to those facilities that health care services
provide to enable patients to manage their health better.
It includes the provision of health information, patient education, telephone-based support and the aid of a support
group [15].
Little is known about the impact of standardized SMS
programs on disease progression and morbidity in CKD
patients. To evaluate the influence of SMS in CKD care,
we conducted an open-label, randomized controlled trial
of late-stage CKD (Stages III–V) patients. The aim of
the study was to investigate the effect of SMS on CKD
progression. The results could be important in establishing
the role of SMS in the daily care of CKD patients.
Materi (...truncated)
