Korean J Clin Pharm.
2016 Dec;26(4):318-323. 10.0000/kjcp.2016.26.4.318.
Clinical Outcomes of Multidisciplinary Team Care on the Regulation of Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) in Patients Undergoing Dialysis
- Affiliations
-
- 1College of Pharmacy, Chungnam National University, Daejeon 34134, Republic of Korea.
- 2College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul 08826, Republic of Korea. jmoh@snu.ac.kr
- 3College of Pharmacy, Gachon University, Incheon 21936, Republic of Korea.
- 4Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea.
- KMID: 2369009
- DOI: http://doi.org/10.0000/kjcp.2016.26.4.318
Abstract
- BACKGROUND
Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients.
METHODS
This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product (cCa×P), and the prescription rate of non-calcium based P-binders.
RESULTS
A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target cCa×P level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher cCa×P levels than 55 mg²/dL² (P <0.001).
CONCLUSION
It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Diagnosis and Management of Chronic Kidney Disease-Mineral Bone Disease in Children
- Osteoporosis in Patients with Chronic Kidney Disease
- Gaps between Global Guidelines and Local Practices in CKD-MBD
- Chronic Kidney Disease-mineral Bone Disorder and Active Vitamin D Analogs for Treating Severe Hyperparathyroidism in Children Receiving Chronic Peritoneal Dialysis
- Current Understanding of Mineral and Bone Disorders of Chronic Kidney Disease and the Scientific Grounds on the Use of Exogenous Parathyroid Hormone in Its Management
