The Multidisciplinary Individual Team Approach to the Patients With Diabetic Nephropathy at Predialysis Improves the Pathophysiology During the Initiation of Hemodialysis and the Prognosis After Hemodialysis

Abstract

We examined the relationship between a multidisciplinary individual team approach (MTA) and the hemodialysis (HD) course and prognosis after HD compared to only a dietitian approach (ODA). Sixty-nine diabetic patients with diabetic nephropathy (DN) receiving HD periodically from 2010 to 2016 were examined. The duration from a creatinine value of 2.0 mg/dL to HD induction in MTA was significantly longer than in ODA. The hemoglobin and hematocrit values, cardiothoracic ratio, hospitalization and costs were significantly better for MTA than ODA. MTA patients more frequently underwent 24-h urine collection than did ODA patients. The survival rate from baseline in MTA patients was significantly longer than in ODA patients. The MTA might have beneficial effects on the HD course and prognosis in patients with DN, since various staff members provide multiple and broad information on the present and future clinical condition as well as self-management.