Adherence to multidisciplinary care in a prospective chronic kidney disease cohort is associated with better outcomes

Ríos, Pablo - Sola, Laura - Ferreiro, Alejandro - Silvariño, Ricardo - Lamadrid, Verónica - Ceretta, Laura - Gadola, Liliana

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.

Detalles Bibliográficos
2022
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
Inglés
Universidad de la República
COLIBRI
https://hdl.handle.net/20.500.12008/54623
Acceso abierto
Licencia Creative Commons Atribución (CC - By 4.0)
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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.
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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.
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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.
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repository.mail.fl_str_mv karina.camps@seciu.edu.uy
repository.name.fl_str_mv COLIBRI - Universidad de la República
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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