A Challenges are in preventing and controlling Chronic kidney disease of Thailand.

Abstract

      Thailand has one of the highest rates of chronic kidney disease (CKD) in the world, ranking among the top five, with nearly 10 million patients and a high economic burden of 1.6 trillion baht per year. This developmental research aimed to analyze the challenges and develop an appropriate model for preventing and controlling CKD in the Thai context. The sample consisted of quantitative and qualitative CKD patients in stages 2-4, using a participatory focus group process with experts.

      The research found that most of patients also had hypertension and diabetes. The disease prevalence was as high as 17.6%, with 40% of patients diagnosed in stage 3. Health behaviors to slow kidney deterioration in CKD patients before and after participating in the program showed statistically significant differences (p < .001) in dietary, exercise, and mental health care. This led to improved health behaviors and slowed kidney deterioration, with an increase in the average glomerular filtration rate (eGFR). However, there was no statistically significant difference in medication use. Kidney health outcomes, including laboratory tests before and after the program, showed no statistically significant differences. The research also focused on developing a CKD prevention and promotion model for Chiang Mai province. This is a participatory process involving the thinking, planning, implementation, and evaluation of three pillars: 1) The Service Plan Development Committee of Health Region 1; 2) Public health service units at all levels providing health behavior modification services to slow kidney deterioration; and 3) Patients and their families educating themselves on chronic kidney disease, understanding the disease and risks, planning risk monitoring, managing their own health outcomes, undergoing health check-ups, and modifying behaviors to prevent kidney deterioration. This follows the Ottawa Charter's health promotion guidelines through five strategies: public policy creation, a health-supportive environment, community empowerment, personal skills, and healthcare system improvement.