Challenges and factors affecting the control and prevention of chronic kidney disease in Thailand.

Abstract

      This research was survey study aiming to investigate the challenges and factors affecting the control and prevention of chronic kidney disease (CKD), and to develop policy recommendations for CKD prevention and control. The sample consisted of 300 patients with stage 2-4 CKD, aged 35-70 years, receiving treatment at target hospitals in four target districts of Chiang Mai Province. Data were collected using the G*power program, with purposive and voluntary selection. Data were analyzed using descriptive statistics including frequency, percentage, mean, standard deviation, and t-test.

      The study found that the main challenges can be divided into three dimensions: 1) Behavioral dimension of the population, such as consuming salty foods, lack of awareness of early kidney failure, inappropriate medication use, and economic limitations affecting access to treatment; 2) Healthcare system dimension, including insufficient screening of at-risk groups, inadequate public health personnel, and incomplete interconnected health information systems; and 3) Policy and management dimension, such as inadequate policy enforcement, project sustainability, and limitations in providing treatment services. The study results reflect the need to improve early screening, develop the healthcare system, and raise awareness of prevention to support the Ministry of Public Health's Decade of Slowing Kidney Deterioration policy and lead to a sustainable long-term reduction of the burden of chronic kidney disease. Factors affecting the control and prevention of chronic kidney disease are mostly associated with comorbidities such as hypertension, hyperlipidemia, and diabetes. Contributing factors to chronic kidney disease include drinking less than 8 glasses of water per day, urinary incontinence, taking pain relievers, combination drugs, and anti-inflammatory drugs, anxiety, frequent stress, alcohol consumption, and regular use of herbal remedies and supplements. Most patients received knowledge on how to slow kidney deterioration in chronic kidney disease patients. Policy recommendations include: 1) The government declaring the decade of chronic kidney disease control and prevention as a national agenda; 2) The Ministry of Public Health establishing a chronic kidney disease management system, starting from screening at-risk groups, disease prevention, treatment, and monitoring, aiming to reduce chronic kidney disease; 3) Multidisciplinary healthcare units providing a continuous and comprehensive patient care system; and 4) The public having access to, being aware of, and understanding how to control risk factors related to health behaviors and avoiding potential health impacts.