| Title | Self-management interventions for chronic kidney disease: a systematic review and meta-analysis |
| Authors | Peng, Suyuan He, Jiawei Huang, Jiasheng Lun, Longwei Zeng, Jiahao Zeng, Shan Zhang, La Liu, Xusheng Wu, Yifan |
| Affiliation | Guangzhou Univ Chinese Med, Med Coll 2, Guangzhou, Guangdong, Peoples R China Mayo Clin, Hlth Sci Res, Rochester, MN USA Peking Univ, Hosp 1, Renal Div, Beijing, Peoples R China Guangzhou Univ Chinese Med, Nephrol Dept, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou, Guangdong, Peoples R China Guangzhou Univ Chinese Med, Chron Dis Management Dept, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, 111 Dade Rd, Guangzhou, Guangdong, Peoples R China Guangzhou Univ Chinese Med, EBM & Clin Res Serv Grp, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou, Guangdong, Peoples R China Guangdong Prov Acad Chinese Med Sci, Guangzhou, Guangdong, Peoples R China |
| Keywords | Chronic kidney disease Self-management Chronic disease management |
| Issue Date | 2019 |
| Publisher | BMC NEPHROLOGY |
| Abstract | BackgroundSelf-management intervention aims to facilitate an individual's ability to make lifestyle changes. The effectiveness of this intervention in non-dialysis patients with chronic kidney disease (CKD) is limited. In this study, we applied a systematic review and meta-analysis to investigate whether self-management intervention improves renoprotection for non-dialysis chronic kidney disease.MethodsWe conducted a comprehensive search for randomized controlled trials addressing our objective. We searched for studies up to May 12, 2018. Two reviewers independently evaluated study quality and extracted characteristics and outcomes among patients with CKD within the intervention phase for each trial. Meta-regression and subgroup analyses were conducted to explore heterogeneity.ResultsWe identified 19 studies with a total of 2540 CKD patients and a mean follow-up of 13.44months. Compared with usual care, self-management intervention did not show a significant difference for risk of all-cause mortality (5 studies, 1662 participants; RR 1.13; 95% CI 0.68 to 1.86; I-2=0%), risk of dialysis (5 studies, 1565 participants; RR 1.35; 95% CI 0.84 to 2.19; I-2=0%), or change in eGFR (8 studies, 1315 participants; SMD -0.01; 95% CI -0.23 to 0.21; I-2=64%). Moreover, self-management interventions were associated with a lower 24h urinary protein excretion (4 studies, 905 participants; MD -0.12g/24h; 95% CI -0.21 to -0.02; I-2=3%), a lower blood pressure level (SBP: 7 studies, 1201 participants; MD -5.68mmHg; 95%CI -9.68 to -1.67; I-2=60%; DBP: 7 studies, 1201 participants; MD -2.64mmHg, 95% CI -3.78 to -1.50; I-2=0%), a lower C-reactive Protein (CRP) level (3 studies, 123 participants; SMD -2.8; 95% CI -2.90 to -2.70; I-2=0%) and a longer distance on the 6-min walk (3 studies, 277 participants; SMD 0.70; 95% CI 0.45 to 0.94; I-2=0%) when compared with the control group.ConclusionsWe observed that self-management intervention was beneficial for urine protein decline, blood pressure level, exercise capacity and CRP level, compared with the standard treatment, during a follow-up of 13.44months in patients with CKD non-dialysis. However, it did not provide additional benefits for renal outcomes and all-cause mortality. |
| URI | http://hdl.handle.net/20.500.11897/548960 |
| ISSN | 1471-2369 |
| DOI | 10.1186/s12882-019-1309-y |
| Indexed | SCI(E) SSCI(E) |
| Appears in Collections: | 第一医院 |
