METHODS: The newly developed CKDPS instrument was tested on 300 patients with diabetes mellitus in a cross-sectional study. The number of domains, model-fit index, construct validity, and internal consistency of this instrument were determined using exploratory (EFA) and confirmatory factor analysis (CFA).
RESULTS: The EFA yielded nine domains: illness identity, timeline motivation, medical practice and co-operation for Social Psychology, and perceived benefit, perceived barriers, perceived susceptibility, perceived severity, and perceived cue to action for HBM. Four items with low factor loading were removed. CFA yielded the following fit indices for Social Psychology: the goodness of fit index (GFI) = 0.889, comparative fit index (CFI) = 0.934, root mean square error of approximation (RMSEA) = 0.053, normed chi-square (NC) = 1.831; and the following for HBM: GFI = 0.834, CFI = 0.957, RMSEA = 0.053, NC = 1.830. Values of Cronbach's α ranged between 0.760 and 0.909.
CONCLUSIONS: The CKDPS includes 61 questions across nine domains, divided under two categories of Social Psychology and HBM. It is also a valid and reliable tool for measuring diabetic patients' perception of CKD prevention that can be used in larger studies.
Methods: Primary data were collected through a standardized survey, and secondary data analysis was used to derive estimates of the ESRD expenditure.
Results: Total annual expenditure of ESRD by the public sector has grown 94% within a span of 7 years, from Malaysian Ringgit [MYR] 572 million (US dollars [USD] 405 million, purchasing power parity [PPP] 2010) in 2010 to MYR 1.12 billion (USD 785 million, PPP 2016) in 2016. The total ESRD expenditure in 2010 constituted 2.95% of the public sector's total health expenditure, whereas in 2016, the proportion has increased to 4.2%. Only 6% of ESRD expenditure was spent on renal transplantation, and the remaining 94% was spent on dialysis.
Conclusion: The share of ESRD expenditure in total health expenditure for the public sector is considered substantial given only a small proportion of the population is affected by the disease. The rapid increase in expenditure relative to the national total health expenditure should warrant the relevant authorities about sustainability of the existing financing mechanism of ESRD and the importance to institutionalize more drastic preventive measures.
METHODS: MEDLINE and Embase databases were searched from inception up to September 2019 to identify all studies that compared the predictive performance of cystatin C- and/or creatinine-based eGFR in predicting the clearance of vancomycin. The prediction errors (PEs) (the value of eGFR equations minus vancomycin clearance) were quantified for each equation and were pooled using a random-effects model. The root mean squared errors were also quantified to provide a metric for imprecision.
RESULTS: This meta-analysis included evaluations of seven different cystatin C- and creatinine-based eGFR equations in total from 26 studies and 1,234 patients. The mean PE (MPE) for cystatin C-based eGFR was 4.378 mL min-1 (95% confidence interval [CI], -29.425, 38.181), while the creatinine-based eGFR provided an MPE of 27.617 mL min-1 (95% CI, 8.675, 46.560) in predicting clearance of vancomycin. This indicates the presence of unbiased results in vancomycin clearance prediction by the cystatin C-based eGFR equations. Meanwhile, creatinine-based eGFR equations demonstrated a statistically significant positive bias in vancomycin clearance prediction.
CONCLUSION: Cystatin C-based eGFR equations are better than creatinine-based eGFR equations in predicting the clearance of vancomycin. This suggests that utilising cystatin C-based eGFR equations could result in better accuracy and precision to predict vancomycin pharmacokinetic parameters.
METHODS AND ANALYSIS: This two-phase sequential explanatory mixed-methods design, incorporating a quantitative design (phase I) and a qualitative study (phase II), is to be conducted in 4 government hospitals and 10 other non-governmental organisations or private dialysis centres within Klang Valley, Malaysia. A cross-sectional survey (phase I) will include 236 patient-caregiver dyads, while focus group discussions (phase II) will include 30 participants. The participants for both phases will be recruited purposively. Descriptive statistics, independent sample t-tests and multiple regression analysis will be used for analyses in phase I, and thematic analysis will be used in phase II.
ETHICS AND DISSEMINATION: Approval for the study has been obtained from the National Medical Research and Ethics Committee (MREC) (NMRR-21-1012-59714) and the Research Ethics Committee of Hospital Canselor Tuanku Muhriz UKM (UKM PPI/111/8/JEP-2021-078) and University of Malaya Medical Centre (MREC ID NO: 2 02 178-10346). Informed consent of the participants will be obtained beforehand, and no personal identifiers will be obtained from the participants to protect their anonymity. The findings will be published in peer-reviewed scientific journals and presented at national or international conferences with minimal anonymised data.
METHOD: Participants comprised of 200 patients experiencing various stages of chronic kidney disease. All participants completed the Short-Form 36 (SF-36), Big Five Inventory (BFI) and the Medical Outcomes Study (MOS) Social Support questionnaires.
RESULTS: Participants consisted of 108 males (54.0%) and 92 females (46.0%) with the mean age of 59.3 years (SD 14.5). Results showed that higher levels of extraversion and lower perceived affectionate social support were associated with higher physical HRQoL, whereas higher levels of neuroticism were associated with poorer mental HRQoL.
CONCLUSION: The current study found that certain personality traits, namely extraversion and neuroticism, were found to be associated with HRQoL. In addition, affectionate social support was also associated with higher HRQoL. Therefore, special attention should be paid to the personality of CKD patients, as well as the type of social support that they have, in planning interventions to improve their health outcomes.