Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes
Resumen:
Introduction: The Renal Healthcare Program Uruguay (NRHP-UY) is a national, multidisciplinary program that provides care to chronic kidney disease (CKD) patients. In this study, we report the global results of CKD patient outcomes and a comparison between those treated at the NRHP-UY Units, with those patients who were initially included in the program but did not adhere to follow up. Methods: A cohort of not-on dialysis CKD patients included prospectively in the NRHP-UY between October 1st 2004 and September 30th 2017 was followed-up until September 30th 2019. Two groups were compared: a) Nephrocare Group: Patients who had at least one clinic visit during the first year on NRHP-UY (n = 11174) and b) Non-adherent Group: Patients who were informed and accepted to be included but had no subsequent data registered after admission (n = 3485). The study was approved by the Ethics Committee and all patients signed an informed consent. Outcomes were studied with Logistic and Cox´s regression analysis, Fine and Gray competitive risk and propensity-score matching tests. Results: 14659 patients were analyzed, median age 70 (60-77) years, 56.9% male. The Nephrocare Group showed improved achievement of therapeutic goals, ESKD was more frequent (HR 2.081, CI 95%1.722-2.514) as planned kidney replacement therapy (KRT) start (OR 2.494, CI95% 1.591-3.910), but mortality and the combined event (death and ESKD) were less frequent (HR 0.671, CI95% 0.628-0.717 and 0.777, CI95% 0.731-0.827) (p = 0.000) compared to the Non-adherent group. Results were similar in the propensity-matched group: ESKD (HR 2.041, CI95% 1.643-2.534); planned kidney replacement therapy (KRT) start (OR 2.191, CI95% 1.322-3.631) death (HR 0.692, CI95% 0.637-0.753); combined event (HR 0.801, CI95% 0.742-0.865) (p = 0.000). Conclusion: Multidisciplinary care within the NRHP-UY is associated with timely initiation of KRT and lower mortality in single outcomes, combined analysis, and propensity-matched analysis.
| 2022 | |
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FALLO RENAL CRÓNICO PERSONA DE MEDIANA EDAD ANCIANO HUMANOS PROGRESIÓN DE LA ENFERMEDAD ESTUDIOS DE COHORTES INSUFICIENCIA RENAL CRÓNICA TERAPÉUTICA ESTUDIOS PROSPECTIVOS TERAPIA DE REEMPLAZO RENAL |
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| Inglés | |
| Universidad de la República | |
| COLIBRI | |
| https://hdl.handle.net/20.500.12008/54623 | |
| Acceso abierto | |
| Licencia Creative Commons Atribución (CC - By 4.0) |
| _version_ | 1872865103224766464 |
|---|---|
| author | Ríos, Pablo |
| author2 | Sola, Laura Ferreiro, Alejandro Silvariño, Ricardo Lamadrid, Verónica Ceretta, Laura Gadola, Liliana |
| author2_role | author author author author author author |
| author_facet | Ríos, Pablo Sola, Laura Ferreiro, Alejandro Silvariño, Ricardo Lamadrid, Verónica Ceretta, Laura Gadola, Liliana |
| author_role | author |
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| collection | COLIBRI |
| dc.contributor.filiacion.none.fl_str_mv | Ríos Pablo, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud Renal Sola Laura, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud Renal Ferreiro Alejandro, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de Nefrología Silvariño Ricardo, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de Nefrología Lamadrid Verónica, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud Renal Ceretta Laura, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud Renal Gadola Liliana, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud Renal |
| dc.creator.none.fl_str_mv | Ríos, Pablo Sola, Laura Ferreiro, Alejandro Silvariño, Ricardo Lamadrid, Verónica Ceretta, Laura Gadola, Liliana |
| dc.date.accessioned.none.fl_str_mv | 2026-04-27T22:51:51Z |
| dc.date.available.none.fl_str_mv | 2026-04-27T22:51:51Z |
| dc.date.issued.none.fl_str_mv | 2022 |
| dc.description.abstract.none.fl_txt_mv | Introduction: The Renal Healthcare Program Uruguay (NRHP-UY) is a national, multidisciplinary program that provides care to chronic kidney disease (CKD) patients. In this study, we report the global results of CKD patient outcomes and a comparison between those treated at the NRHP-UY Units, with those patients who were initially included in the program but did not adhere to follow up. Methods: A cohort of not-on dialysis CKD patients included prospectively in the NRHP-UY between October 1st 2004 and September 30th 2017 was followed-up until September 30th 2019. Two groups were compared: a) Nephrocare Group: Patients who had at least one clinic visit during the first year on NRHP-UY (n = 11174) and b) Non-adherent Group: Patients who were informed and accepted to be included but had no subsequent data registered after admission (n = 3485). The study was approved by the Ethics Committee and all patients signed an informed consent. Outcomes were studied with Logistic and Cox´s regression analysis, Fine and Gray competitive risk and propensity-score matching tests. Results: 14659 patients were analyzed, median age 70 (60-77) years, 56.9% male. The Nephrocare Group showed improved achievement of therapeutic goals, ESKD was more frequent (HR 2.081, CI 95%1.722-2.514) as planned kidney replacement therapy (KRT) start (OR 2.494, CI95% 1.591-3.910), but mortality and the combined event (death and ESKD) were less frequent (HR 0.671, CI95% 0.628-0.717 and 0.777, CI95% 0.731-0.827) (p = 0.000) compared to the Non-adherent group. Results were similar in the propensity-matched group: ESKD (HR 2.041, CI95% 1.643-2.534); planned kidney replacement therapy (KRT) start (OR 2.191, CI95% 1.322-3.631) death (HR 0.692, CI95% 0.637-0.753); combined event (HR 0.801, CI95% 0.742-0.865) (p = 0.000). Conclusion: Multidisciplinary care within the NRHP-UY is associated with timely initiation of KRT and lower mortality in single outcomes, combined analysis, and propensity-matched analysis. |
| dc.format.extent.es.fl_str_mv | 21 p. |
| dc.format.mimetype.es.fl_str_mv | application/pdf |
| dc.identifier.citation.es.fl_str_mv | Ríos P, Sola L, Ferreiro A y otros. Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes. PLoS ONE [en línea]. 2022;17(10). 21 p. |
| dc.identifier.doi.none.fl_str_mv | 10.1371/journal.pone.0266617 |
| dc.identifier.eissn.none.fl_str_mv | 1932-6203 |
| dc.identifier.uri.none.fl_str_mv | https://hdl.handle.net/20.500.12008/54623 |
| dc.language.iso.none.fl_str_mv | en eng |
| dc.publisher.es.fl_str_mv | Public Library of Science |
| dc.relation.none.fl_str_mv | PLoS ONE. 2022;17(10) |
| dc.rights.license.none.fl_str_mv | Licencia Creative Commons Atribución (CC - By 4.0) |
| dc.rights.none.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.source.none.fl_str_mv | reponame:COLIBRI instname:Universidad de la República instacron:Universidad de la República |
| dc.subject.other.es.fl_str_mv | FALLO RENAL CRÓNICO PERSONA DE MEDIANA EDAD ANCIANO HUMANOS PROGRESIÓN DE LA ENFERMEDAD ESTUDIOS DE COHORTES INSUFICIENCIA RENAL CRÓNICA TERAPÉUTICA ESTUDIOS PROSPECTIVOS TERAPIA DE REEMPLAZO RENAL |
| dc.title.none.fl_str_mv | Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes |
| dc.type.es.fl_str_mv | Artículo |
| dc.type.none.fl_str_mv | info:eu-repo/semantics/article |
| dc.type.version.none.fl_str_mv | info:eu-repo/semantics/publishedVersion |
| description | Introduction: The Renal Healthcare Program Uruguay (NRHP-UY) is a national, multidisciplinary program that provides care to chronic kidney disease (CKD) patients. In this study, we report the global results of CKD patient outcomes and a comparison between those treated at the NRHP-UY Units, with those patients who were initially included in the program but did not adhere to follow up. Methods: A cohort of not-on dialysis CKD patients included prospectively in the NRHP-UY between October 1st 2004 and September 30th 2017 was followed-up until September 30th 2019. Two groups were compared: a) Nephrocare Group: Patients who had at least one clinic visit during the first year on NRHP-UY (n = 11174) and b) Non-adherent Group: Patients who were informed and accepted to be included but had no subsequent data registered after admission (n = 3485). The study was approved by the Ethics Committee and all patients signed an informed consent. Outcomes were studied with Logistic and Cox´s regression analysis, Fine and Gray competitive risk and propensity-score matching tests. Results: 14659 patients were analyzed, median age 70 (60-77) years, 56.9% male. The Nephrocare Group showed improved achievement of therapeutic goals, ESKD was more frequent (HR 2.081, CI 95%1.722-2.514) as planned kidney replacement therapy (KRT) start (OR 2.494, CI95% 1.591-3.910), but mortality and the combined event (death and ESKD) were less frequent (HR 0.671, CI95% 0.628-0.717 and 0.777, CI95% 0.731-0.827) (p = 0.000) compared to the Non-adherent group. Results were similar in the propensity-matched group: ESKD (HR 2.041, CI95% 1.643-2.534); planned kidney replacement therapy (KRT) start (OR 2.191, CI95% 1.322-3.631) death (HR 0.692, CI95% 0.637-0.753); combined event (HR 0.801, CI95% 0.742-0.865) (p = 0.000). Conclusion: Multidisciplinary care within the NRHP-UY is associated with timely initiation of KRT and lower mortality in single outcomes, combined analysis, and propensity-matched analysis. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | COLIBRI_959335c7f5f971d1d8e437c13e625e8e |
| identifier_str_mv | Ríos P, Sola L, Ferreiro A y otros. Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes. PLoS ONE [en línea]. 2022;17(10). 21 p. 10.1371/journal.pone.0266617 1932-6203 |
| instacron_str | Universidad de la República |
| institution | Universidad de la República |
| instname_str | Universidad de la República |
| language | eng |
| language_invalid_str_mv | en |
| network_acronym_str | COLIBRI |
| network_name_str | COLIBRI |
| oai_identifier_str | oai:colibri.udelar.edu.uy:20.500.12008/54623 |
| publishDate | 2022 |
| reponame_str | COLIBRI |
| repository.mail.fl_str_mv | karina.camps@seciu.edu.uy |
| repository.name.fl_str_mv | COLIBRI - Universidad de la República |
| repository_id_str | 4771 |
| rights_invalid_str_mv | Licencia Creative Commons Atribución (CC - By 4.0) |
| spelling | Ríos Pablo, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud RenalSola Laura, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud RenalFerreiro Alejandro, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de NefrologíaSilvariño Ricardo, Universidad de la República (Uruguay). Facultad de Medicina. Departamento de NefrologíaLamadrid Verónica, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud RenalCeretta Laura, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud RenalGadola Liliana, Fondo Nacional de Recursos (Uruguay). Comisión Asesora de Programa de Salud Renal2026-04-27T22:51:51Z2026-04-27T22:51:51Z2022Ríos P, Sola L, Ferreiro A y otros. Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes. PLoS ONE [en línea]. 2022;17(10). 21 p.https://hdl.handle.net/20.500.12008/5462310.1371/journal.pone.02666171932-6203Introduction: The Renal Healthcare Program Uruguay (NRHP-UY) is a national, multidisciplinary program that provides care to chronic kidney disease (CKD) patients. In this study, we report the global results of CKD patient outcomes and a comparison between those treated at the NRHP-UY Units, with those patients who were initially included in the program but did not adhere to follow up. Methods: A cohort of not-on dialysis CKD patients included prospectively in the NRHP-UY between October 1st 2004 and September 30th 2017 was followed-up until September 30th 2019. Two groups were compared: a) Nephrocare Group: Patients who had at least one clinic visit during the first year on NRHP-UY (n = 11174) and b) Non-adherent Group: Patients who were informed and accepted to be included but had no subsequent data registered after admission (n = 3485). The study was approved by the Ethics Committee and all patients signed an informed consent. Outcomes were studied with Logistic and Cox´s regression analysis, Fine and Gray competitive risk and propensity-score matching tests. Results: 14659 patients were analyzed, median age 70 (60-77) years, 56.9% male. The Nephrocare Group showed improved achievement of therapeutic goals, ESKD was more frequent (HR 2.081, CI 95%1.722-2.514) as planned kidney replacement therapy (KRT) start (OR 2.494, CI95% 1.591-3.910), but mortality and the combined event (death and ESKD) were less frequent (HR 0.671, CI95% 0.628-0.717 and 0.777, CI95% 0.731-0.827) (p = 0.000) compared to the Non-adherent group. Results were similar in the propensity-matched group: ESKD (HR 2.041, CI95% 1.643-2.534); planned kidney replacement therapy (KRT) start (OR 2.191, CI95% 1.322-3.631) death (HR 0.692, CI95% 0.637-0.753); combined event (HR 0.801, CI95% 0.742-0.865) (p = 0.000). Conclusion: Multidisciplinary care within the NRHP-UY is associated with timely initiation of KRT and lower mortality in single outcomes, combined analysis, and propensity-matched analysis.Submitted by Almiñana María Cecilia (marialminana@gmail.com) on 2026-04-27T15:46:46Z No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Adherence to multidisciplinary care in a prospective chronic kidney disease.pdf: 1471748 bytes, checksum: 82b1673c0114c3c0523aeed323f96a7b (MD5)Approved for entry into archive by Almiñana María Cecilia (marialminana@gmail.com) on 2026-04-27T15:49:30Z (GMT) No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Adherence to multidisciplinary care in a prospective chronic kidney disease.pdf: 1471748 bytes, checksum: 82b1673c0114c3c0523aeed323f96a7b (MD5)Made available in DSpace by Camps Karina (karina.camps@seciu.edu.uy) on 2026-04-27T22:51:51Z (GMT). No. of bitstreams: 2 license_rdf: 25630 bytes, checksum: e7132498e7c1fe99f7096667baa99b25 (MD5) Adherence to multidisciplinary care in a prospective chronic kidney disease.pdf: 1471748 bytes, checksum: 82b1673c0114c3c0523aeed323f96a7b (MD5) Previous issue date: 202221 p.application/pdfenengPublic Library of SciencePLoS ONE. 2022;17(10)Las obras depositadas en el Repositorio se rigen por la Ordenanza de los Derechos de la Propiedad Intelectual de la Universidad de la República.(Res. Nº 91 de C.D.C. de 8/III/1994 – D.O. 7/IV/1994) y por la Ordenanza del Repositorio Abierto de la Universidad de la República (Res. Nº 16 de C.D.C. de 07/10/2014)info:eu-repo/semantics/openAccessLicencia Creative Commons Atribución (CC - By 4.0)FALLO RENAL CRÓNICOPERSONA DE MEDIANA EDADANCIANOHUMANOSPROGRESIÓN DE LA ENFERMEDADESTUDIOS DE COHORTESINSUFICIENCIA RENAL CRÓNICATERAPÉUTICAESTUDIOS PROSPECTIVOSTERAPIA DE REEMPLAZO RENALAdherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomesArtículoinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionreponame:COLIBRIinstname:Universidad de la Repúblicainstacron:Universidad de la RepúblicaRíos, PabloSola, LauraFerreiro, AlejandroSilvariño, RicardoLamadrid, VerónicaCeretta, LauraGadola, LilianaLICENSElicense.txtlicense.txttext/plain; charset=utf-84267http://localhost:8080/xmlui/bitstream/20.500.12008/54623/5/license.txt6429389a7df7277b72b7924fdc7d47a9MD55CC-LICENSElicense_urllicense_urltext/plain; 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públicahttps://udelar.edu.uy/https://www.colibri.udelar.edu.uy/oai/requestkarina.camps@seciu.edu.uyUruguayopendoar:47712026-04-27T22:51:51COLIBRI - Universidad de la Repúblicafalse |
| spellingShingle | Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes Ríos, Pablo FALLO RENAL CRÓNICO PERSONA DE MEDIANA EDAD ANCIANO HUMANOS PROGRESIÓN DE LA ENFERMEDAD ESTUDIOS DE COHORTES INSUFICIENCIA RENAL CRÓNICA TERAPÉUTICA ESTUDIOS PROSPECTIVOS TERAPIA DE REEMPLAZO RENAL |
| status_str | publishedVersion |
| title | Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes |
| title_full | Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes |
| title_fullStr | Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes |
| title_full_unstemmed | Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes |
| title_short | Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes |
| title_sort | Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes |
| topic | FALLO RENAL CRÓNICO PERSONA DE MEDIANA EDAD ANCIANO HUMANOS PROGRESIÓN DE LA ENFERMEDAD ESTUDIOS DE COHORTES INSUFICIENCIA RENAL CRÓNICA TERAPÉUTICA ESTUDIOS PROSPECTIVOS TERAPIA DE REEMPLAZO RENAL |
| url | https://hdl.handle.net/20.500.12008/54623 |