BƯỚC ĐẦU ĐÁNH GIÁ KẾT QUẢ CÁC BIỆN PHÁP CAN THIỆP ĐẾN TIẾN TRIỂN BỆNH THẬN MẠN GIAI ĐOẠN III TẠI THÀNH PHỐ CẦN THƠ

Abstract

Background: Chronic kidney disease (CKD) represents a growing public health challenge worldwide. In the Mekong Delta, particularly in Can Tho City, the increasing prevalence highlights the urgent need to evaluate early-stage interventions to prevent irreversible renal decline. Objectives: This study aimed to preliminarily evaluate the effectiveness of comprehensive interventions on the progression of stage III CKD in Can Tho City, Vietnam. Materials and methods: A pre–post interventional study without a control group was conducted on 34 patients diagnosed with stage III CKD according to KDIGO 2021 criteria. Interventions included lifestyle modifications (smoking cessation, physical activity, weight management, and dietary adjustments) and medical management (blood pressure control to <130/80 mmHg, glycemic control with HbA1c <7.0%, and administration of Dapagliflozin 10 mg/day for all patients). Participants were followed for 12 months to assess changes in estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR). Intervention efficacy was defined as an annual eGFR decline ≤5 mL/min/1.73 m². Results: The mean age was 71.8±9.3 years, with 61.8% female patients. Common related factors included NSAID use (76.5%), recurrent nephrolithiasis or urinary tract infection (55.9%), hypertension (52.9%), and diabetes mellitus (38.2%). After 12 months, 44.1% of patients showed improved eGFR, with a mean increase of 11.36±9.38 mL/min/1.73 m² in the improvement group. The overall rate of slowed disease progression was 58.8%, whereas 23.5% of patients progressed to a more advanced stage. Most patients exhibited a decreased or stable ACR. Conclusion: Preliminary findings suggest that the applied interventions achieved renal function preservation in 58.8% of patients, indicating a potential benefit in delaying CKD progression.