{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:51:39Z","timestamp":1772988699743,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":61,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2019YFE0196300"],"award-info":[{"award-number":["2019YFE0196300"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013068","name":"Key Technologies Research and Development Program of Guangzhou","doi-asserted-by":"publisher","award":["202206010102"],"award-info":[{"award-number":["202206010102"]}],"id":[{"id":"10.13039\/501100013068","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010840","name":"Guangdong Provincial Academy of Chinese Medical Sciences","doi-asserted-by":"publisher","award":["SZ2022QN07"],"award-info":[{"award-number":["SZ2022QN07"]}],"id":[{"id":"10.13039\/501100010840","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Self\u2010management (SMP) is a novel treatment comprised of multidimensional interventions. Researchers have reported its reliable effects on short\u2010term improvements in surrogate indicators like 24\u2010h urinary protein excretion and systolic blood pressure. However, whether it has any effect on long\u2010term changes in other surrogate indicators and chronic kidney disease (CKD) endpoints remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with CKD stages 3\u20104 were grouped into either a SMP group or a nonself\u2010management (non\u2010SMP) group whether they had complied any of five characterized elements: regular visits, medication adjustment, nutritional intervention, lifestyle modification, education, and behavior guide. We used 1:1 nearest\u2010neighbor propensity score matching (PSM) to balance between\u2010group differences. Cox regression was used to explore the long\u2010term association between SMP and composite outcomes (all\u2010cause mortality, end\u2010stage kidney disease (ESKD), \u2265\u200950% decline in estimated glomerular filtration rate (eGFR), or doubling of serum creatinine (SCr) from baseline). Linear mixed\u2010effects (LME) model and marginal means comparisons were used to surrogate indicators analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 1160 patients with a median follow\u2010up of 27.20\u2009months. Among them, 580 individuals were in the SMP group and 580 were in the non\u2010SMP group. In the non\u2010SMP group, the median follow\u2010up was 24.48 (12.21, 43.39) months with 174 (30.00%) events, whereas the SMP group had a median follow\u2010up of 29.34 (14.75, 42.00) months with 134 (23.10%) composite outcomes. Participation in a SMP program was associated with a 30.9% reduction in CKD progression risk (hazard ratio (HR) of composite outcome: 0.691, 95% CI: 0.549\u20130.869, and\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002). LME and marginal means comparison indicated that patients with SMP had higher mean difference of eGFR and serum albumin (Alb) than the non\u2010SMP individuals (mean difference of eGFR: 1.791 (0.721, 2.861) mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001; marginal mean difference of eGFR: 2.560 (1.660, 3.470) mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001; mean difference of Alb: 0.654 (0.202, 1.105) g\/L,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005; and marginal mean difference of Alb: 0.460 (0.166, 0.753) g\/L,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SMP programs are associated with a 30.9% reduction in CKD progression risk and improvements in kidney function and nutrition\u2010related surrogate markers, benefiting CKD patients in stages 3\u20104.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/1228799","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T11:37:26Z","timestamp":1772969846000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Self\u2010Management Improves Long\u2010Term CKD Prognosis: A 10\u2010Year Retrospective Cohort Study From 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