The association between the utilization of community-based integrated screening and outcomes of renal function in middle-aged and elderly recipients

  • 王 琦瑩

Student thesis: Doctoral Thesis

Abstract

SUMMARY Although community-based integrated screening has been implemented for 20 years as a national periodic health examination program in Taiwan evidence about the effectiveness of morbidity reduction is sparse Effectiveness of similar nationwide program in other countries has mainly reported on cardiovascular disease related outcomes The aim of this study is to test the hypothesis of higher utilization of community-based integrated screening associated with better renal outcomes We conducted a retrospective cohort study which enrolled participants aged ? 40 years old without baseline kidney disease who attended community-based integrated screening repeatedly in Longci District Tainan City during 2003-2017 In a subgroup analysis participants with baseline hypertension diabetes or cardiovascular diseases were further excluded Screening utilization was either presented as numbers or utilization groups in separate models Three renal health outcomes included annual change in kidney function rapid decline in kidney function and incident chronic kidney disease were analyzed in corresponding statistical methods A total of 935 participants without kidney disease at baseline were followed for 7 4 years Results showed individuals who used screening more than three times had a 42%(OR 0 58 95%CI 0 35-0 96) lower risk of rapid decline in kidney function and 71%(HR 0 29 95%CI 0 18-0 44) lower risk of developing incident chronic kidney disease comparing with individuals who used screening twice only In a subgroup analysis higher screening utilization was associated with more risk reduction in renal health outcomes Government should advise middle-aged and elderly to participate screening regularly and consecutively because of possible benefit of kidney function preservation
Date of Award2019
Original languageEnglish
SupervisorLi-Fan Liu (Supervisor)

Cite this

'