{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T20:12:17Z","timestamp":1772050337570,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T00:00:00Z","timestamp":1612224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We conducted a prospective cohort study to evaluate the effectiveness of an integrated care model on delaying chronic kidney disease (CKD) progression in routine clinical practice in rural primary care setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>After enrolment, patients with stages 3 to 4 CKD patients from five district hospitals in a northern province of Thailand (400\u2009km from Bangkok) received integrated care comprising hospital multidisciplinary care and home visits by community care teams. Clinical characteristics and biochemical data were collected at baseline and every 3\u2010month interval thereafter for 36\u2009months. The primary outcome was the rate of estimated glomerular filtration rate (eGFR) decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine hundred and fourteen stage \u22123 and\u2009\u2212\u20094 CKD patients were enrolled. The mean age of our cohort was 62\u2009years. Diabetic kidney disease (DKD) was the main cause of CKD (53%) whereas hypertension was the most common co\u2010morbidity (92%). The mean rate of eGFR decline was \u22120.92\u2009mL\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>\/year. The rate of eGFR decline among patients with DKD was about three times faster than patients without DKD. Patients with higher blood pressure, metabolic acidosis, proteinuria or anaemia had a faster rate of eGFR decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This integrated care model at the community level was effective in delaying CKD progression in routine clinical practice situation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13849","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T18:12:27Z","timestamp":1610734347000},"page":"333-340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Effectiveness of integrated care on delaying chronic kidney disease progression in rural communities of Thailand (<scp>ESCORT<\/scp>\u20102) trials"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4801-1094","authenticated-orcid":false,"given":"Teerawat","family":"Thanachayanont","sequence":"first","affiliation":[{"name":"Bhumirajanagarindra Kidney Institute  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Methee","family":"Chanpitakkul","sequence":"additional","affiliation":[{"name":"Bhumirajanagarindra Kidney Institute  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jukkapong","family":"Hengtrakulvenit","sequence":"additional","affiliation":[{"name":"Khlong Lan Hospital  Kamphaeng Phet Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Podjanee","family":"Watcharakanon","sequence":"additional","affiliation":[{"name":"Phran Kratai Hospital  Kamphaeng Phet Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Watcharapong","family":"Wisansak","sequence":"additional","affiliation":[{"name":"Saithong Wattana Hospital  Kamphaeng Phet Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teerapong","family":"Tancharoensukjit","sequence":"additional","affiliation":[{"name":"Lan Krabue Hospital  Kamphaeng Phet Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phosri","family":"Kaewsringam","sequence":"additional","affiliation":[{"name":"Khlong Khlung Hospital  Kamphaeng Phet Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vinai","family":"Leesmidt","sequence":"additional","affiliation":[{"name":"Khlong Khlung Hospital  Kamphaeng Phet Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krit","family":"Pongpirul","sequence":"additional","affiliation":[{"name":"Department of Medicine King Chulalongkorn Memorial Hospital, Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salyaveth","family":"Lekagul","sequence":"additional","affiliation":[{"name":"Bhumirajanagarindra Kidney Institute  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kriang","family":"Tungsanga","sequence":"additional","affiliation":[{"name":"Bhumirajanagarindra Kidney Institute  Bangkok Thailand"},{"name":"Department of Medicine King Chulalongkorn Memorial Hospital, Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"ESCORT\u20102 Research Team","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,2]]},"reference":[{"issue":"1","key":"e_1_2_7_2_1","first-page":"1","article-title":"KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"3","author":"Kidney Disease Improving Global Outcomes [KDIGO]","year":"2013","journal-title":"Kidney Int Suppl"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012121222"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2014.07.042"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-000728"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/5.3.246"},{"issue":"3","key":"e_1_2_7_7_1","first-page":"1","article-title":"Facility type and primary care performance in sub\u2010district health promotion hospitals in northern Thailand","volume":"12","author":"Kitreeawutiwong N","year":"2017","journal-title":"PLoS One"},{"key":"e_1_2_7_8_1","unstructured":"Primary Health Care Division Ministry of Public Health Thailand.Village Health Volunteers Database. 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