The Epidemiology Study of Chronic Kidney Disease in Pingtung county– Using A District Hospital of Pingtung county as Example

• Main Authors: Wen-Kuen Wu, 吳文焜
• Other Authors: Hwang-Shang Kou
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/90796782556428971620

碩士 === 高雄醫學大學 === 藥學研究所碩士在職專班 === 98 === The research aims at a sieving analysis of the chronic kidney disease (CKD)patients in a local hospital at Pingtong from 2007 to 2009, concluding the result that as far as the patients in question are concerned, their kidney disease is closely related to such factors as daily diet, lifestyle, ethnic groups (especially hakka and aborigine), medication, hypertension, diabetes, and high cholesterol. Hypertension is a common complication for chronic kidney disease patients. Though they are advised to control their blood pressure under 130/80 mmHg, many patients fail to conform even if they have taken several kinds of anti-hypertension drugs. Hypertension arising from kidney disease may be related to the kidneys failing to release salt; however, there is no final conclusion whether it has anything to do with limited protein or salt intake in patients’ diet. Research subjects: Males and females, aged between 50 and 80, with creatinine level higher than normal 0.6~1.3mg/dl; blood urea nitrogen(BUN) higher than normal serum 6~20mg/dl Questionnaire: Medication compliance, improved diet, and education background. Stages of chronic kidney disease:[1] Stage I--GFR≥90ml/min/1.73m2 with positive urinary protein； Stage II--GFR 60~89 ml/min/1.73m2 with positive urinary protein； Stage III--GFR 30~59ml/min/1.73m2 Stage IV--GFR 15~29ml/min/1.73m2 Stage V--GFR <15ml/min/1.73m2 The kidney disease patients who receive Kidney dialysis have greatly improve their eating habits, taking bland meals with limited protein instead of strong flavored ones. Before receiving kidney dialysis, the kidney disease patents also suffer from hypertension, diabetes, or high cholesterol. As shown in Table 1、Table 2、Table 3、Table 4, the numbers of the patients who received kidney dialysis were increasing from 2007 to 2009, with new patents and death tolls on the increase each year. It can be known from the questionnaire that the residents in the remote countryside of Pingtong are usually poorly informed of chronic kidney disease; as a result, more often than not when the patients are diagnosed to suffer from kidney disease, they are already terminally ill, often alongside with cardiovascular diseases. Besides, National Health Insurance payments are also increasing year by year. Protein restriction and progression of chronic kidney disease：Progression of a variety of chronic kidney diseases (CKD) may be largely due to secondary hemodynamic and metabolic factors, Dietary protein restriction may also be beneficial by exerting nonhemodynamic effects. Multiple well-designed randomized controlled human trials have evaluated both the efficacy and safety of protein restriction in patients with progressive CKD . Moderate protein restriction (0.6 to 0.8 g/kg per day) is associated with a modest but not significant benefit of protein restriction on progression of renal disease. It is generally well tolerated and does not lead to malnutrition in patients with CKD providing caloric goals are met, dietary protein is of high biologic value, and metabolic acidosis is avoided.