ID | 65243 |
フルテキストURL | |
著者 |
Onishi, Yasuhiro
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
Uchida, Haruhito A.
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
Maeshima, Yohei
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
Kaken ID
publons
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Okuyama, Yuka
Japanese Red Cross Society Himeji Hospital
Otaka, Nozomu
Kagawa Prefectural Central Hospital
Ujike, Haruyo
Kagawa Prefectural Central Hospital
Tanaka, Keiko
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
Takeuchi, Hidemi
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
Tsuji, Kenji
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
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Kitagawa, Masashi
National Hospital Organization Okayama Medical Center
Tanabe, Katsuyuki
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
Morinaga, Hiroshi
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
Kinomura, Masaru
Okayama Saiseikai General Hospital
Kitamura, Shinji
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
Kaken ID
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Sugiyama, Hitoshi
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
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Ota, Kosuke
National Hospital Organization Okayama Medical Center
Maruyama, Keisuke
Okayama Saiseikai General Hospital
Hiramatsu, Makoto
Okayama Saiseikai General Hospital,
Oshiro, Yoshiyuki
Kawasaki Medical School General Medical Center
Morioka, Shigeru
Okayama Central Hospital
Takiue, Keiichi
Okayama City Hospital
Omori, Kazuyoshi
Shigei Medical Research Hospital
Fukushima, Masaki
Shigei Medical Research Hospital
Gamou, Naoyuki
Japanese Red Cross Okayama Hospital
Hirata, Hiroshi
Akebono Clinic
Sato, Ryosuke
Sato Clinic
Wada, Jun
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences
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抄録 | Introduction: While chronic kidney disease (CKD) is one of the most important contributors to mortality from non-communicable diseases, the number of nephrologists is limited worldwide. Medical cooperation is a system of cooperation between primary care physicians and nephrological institutions, consisting of nephrologists and multidisciplinary care teams. Although it has been reported that multidisciplinary care teams contribute to the prevention of worsening renal functions and cardiovascular events, there are few studies on the effect of a medical cooperation system. Methods: We aimed to evaluate the effect of medical cooperation on all-cause mortality and renal prognosis in patients with CKD. One hundred and sixty-eight patients who visited the one hundred and sixty-three clinics and seven general hospitals of Okayama city were recruited between December 2009 and September 2016, and one hundred twenty-three patients were classified into a medical cooperation group. The outcome was defined as the incidence of all-cause mortality, or renal composite outcome (end-stage renal disease or 50% eGFR decline). We evaluated the effects on renal composite outcome and pre-ESRD mortality while incorporating the competing risk for the alternate outcome into a Fine-Gray subdistribution hazard model. Results: The medical cooperation group had more patients with glomerulonephritis (35.0% vs. 2.2%) and less nephrosclerosis (35.0% vs. 64.5%) than the primary care group. Throughout the follow-up period of 5.59 +/- 2.78 years, 23 participants (13.7%) died, 41 participants (24.4%) reached 50% decline in eGFR, and 37 participants (22.0%) developed end-stage renal disease (ESRD). All-cause mortality was significantly reduced by medical cooperation (sHR 0.297, 95% CI 0.105-0.835, p = 0.021). However, there was a significant association between medical cooperation and CKD progression (sHR 3.069, 95% CI 1.225-7.687, p = 0.017). Conclusion: We evaluated mortality and ESRD using a CKD cohort with a long-term observation period and concluded that medical cooperation might be expected to influence the quality of medical care in the patients with CKD.
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キーワード | chronic kidney disease (CKD)
medical cooperation
patient care team
OCKD-NET
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発行日 | 2023-03-26
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出版物タイトル |
Journal of Personalized Medicine
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巻 | 13巻
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号 | 4号
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出版者 | MDPI
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開始ページ | 582
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ISSN | 2075-4426
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資料タイプ |
学術雑誌論文
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言語 |
英語
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OAI-PMH Set |
岡山大学
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著作権者 | © 2023 by the authors.
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論文のバージョン | publisher
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PubMed ID | |
DOI | |
Web of Science KeyUT | |
関連URL | isVersionOf https://doi.org/10.3390/jpm13040582
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ライセンス | https://creativecommons.org/licenses/by/4.0/
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Citation | Onishi, Y.; Uchida, H.A.; Maeshima, Y.; Okuyama, Y.; Otaka, N.; Ujike, H.; Tanaka, K.; Takeuchi, H.; Tsuji, K.; Kitagawa, M.; et al. The Effect of Medical Cooperation in the CKD Patients: 10-Year Multicenter Cohort Study. J. Pers. Med. 2023, 13, 582. https://doi.org/10.3390/jpm13040582
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