Publication:
The impact of the quality of care and other factors on progression of chronic kidney disease in Thai patients with Type 2 Diabetes Mellitus: A nationwide cohort study

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Issued Date

2017

Resource Type

Article

File Type

application/pdf

ISSN

19326203

DOI

10.1371/journal.pone.0180977

Other identifier(s)

2-s2.0-85026477348

Rights Holder(s)

Scopus

Bibliographic Citation

PLoS ONE. Vol 12, No.7 (2017)

Suggested Citation

Sonthon P., Promthet S., Changsirikulchai S., Rangsin R., Thinkhamrop B., Rattanamongkolgul S., Hurst C.P. The impact of the quality of care and other factors on progression of chronic kidney disease in Thai patients with Type 2 Diabetes Mellitus: A nationwide cohort study. PLoS ONE. Vol 12, No.7 (2017). doi:10.1371/journal.pone.0180977 Retrieved from: https://hdl.handle.net/20.500.14740/4139

Title

The impact of the quality of care and other factors on progression of chronic kidney disease in Thai patients with Type 2 Diabetes Mellitus: A nationwide cohort study

Author(s)

Sonthon P.
 Promthet S.
 Changsirikulchai S.
 Rangsin R.
 Thinkhamrop B.
 Rattanamongkolgul S.
 Hurst C.P.

Abstract

Objective: The present study investigates the impact of quality of care (QoC) and other factors on chronic kidney disease (CKD) stage progression among Type 2 Diabetes Mellitus (T2DM) patients. Methods: This study employed a retrospective cohort from a nationwide Diabetes and Hypertension study involving 595 Thai hospitals. T2DM patients who were observed at least 2 times in the 3 years follow-up (between 2011–2013) were included in our study. Ordinal logistic mixed effect regression modeling was used to investigate the association between the QoC and other factors with CKD stage progression. Results: After adjusting for covariates, we found that the achievement of the HbA1c clinical targets (≤7%) was the only QoC indicator protective against the CKD stage progression (adjusted OR = 0.76; 95%CI = 0.59–0.98; p<0.05). In terms of other covariates, age, occupation, type of health insurance, region of residence, HDL-C, triglyceride, hypertension and insulin sensitizer were also strongly associated with CKD stage progression. Conclusions: This cohort study demonstrates the achievement of the HbA1c clinical target (≤7%) is the only QoC indicator protective against progression of CKD stage. Neither of the other clinical targets (BP and LDL-C) nor any process of care targets could be shown to be associated with CKD stage progression. Therefore, close monitoring of blood sugar control is important to slow CKD progression, but long-term prospective cohorts are needed to gain better insights into the impact of QoC indicators on CKD progression. © 2017 Sonthon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Subject(s)

Hemoglobin A1c
 High density lipoprotein cholesterol
 Insulin
 Triacylglycerol
 Glycosylated hemoglobin
 Hemoglobin A1c protein, human
 Adult
 Age
 Aged
 Article
 Chronic kidney failure
 Cohort analysis
 Controlled study
 Cross-sectional study
 Disease course
 Female
 Follow up
 Health care quality
 Health insurance
 Human
 Hypertension
 Insulin sensitivity
 Major clinical study
 Male
 Non insulin dependent diabetes mellitus
 Occupation
 Retrospective study
 Thai (people)
 Chronic kidney failure
 Disease course
 Metabolism
 Middle aged
 Non insulin dependent diabetes mellitus
 Pathology
 Thailand
 Very elderly
 Adult
 Age Factors
 Aged
 Aged, 80 and over
 Cohort Studies
 Diabetes Mellitus, Type 2
 Disease Progression
 Female
 Hemoglobin A, Glycosylated
 Humans
 Male
 Middle Aged
 Quality of Health Care
 Renal Insufficiency, Chronic
 Retrospective Studies
 Thailand

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URI

https://hdl.handle.net/20.500.14740/4139

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Scopus: Year 1983-2021

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