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Background: Chronic kidney disease (CKD) refers to permanent damage to the kidneys that occurs gradually over time. Further progression may be preventable depending on its stage. Purpose: This study was developed to evaluate the effect of a health literacy education program (HLEP) on mental health and renal functioning in patients with CKD. Methods: A single-blind, randomized controlled trial study was conducted. Data were collected from March 25 to December 18, 2021. Participants were randomly assigned to either the experimental group (n = 42), which received multidisciplinary care and HLEP, or the control group (n = 42), which received multidisciplinary care only. Data were collected at baseline (T1), Month 3 (T2), and Month 6 (T3), and the data included patient characteristics, estimated glomerular filtration rate, and responses to the Mandarin Multidimensional Health Literacy Questionnaire and Beck Depression Inventory. Results: After 6 months of the HLEP intervention, the results of generalized estimating equations analysis showed that, compared with the control group, the experimental group had significantly higher health literacy at Month 3 (β = −3.37, 95% CI [−5.68, −1.06]), significantly improved depression at Month 3 (β = −2.24, 95% CI [−4.11, −0.37]) and Month 6 (β = −4.36, 95% CI [−6.60, −2.12]), and a significantly higher estimated glomerular filtration rate at Month 6 (β = 5.87, 95% CI [1.35, 10.38]). Conclusions/Implications for Practice: The findings of this study may provide a reference for healthcare providers to educate patients with Stage 3–4 CKD using the HLEP. Positive effects on health literacy, depression, and renal function in patients with Stage 3–4 CKD were observed in the short term. Findings from this study may facilitate the implementation of multidisciplinary and nurse-led strategies in primary care to reinforce patients' health literacy, self-care ability, and adjustment to CKD as well as delay disease progression. [ABSTRACT FROM AUTHOR]

Aim: This study was designed to investigate the longitudinal effect of participating in a self‐management program (SMP) on renal function control in patients receiving hemodialysis. Methods: This randomized controlled trial enrolled a total of 58 patients at the hemodialysis center of a teaching hospital in Taiwan. The control group (n = 30) received the usual care and the experimental group (n = 28) received a 4‐week SMP intervention. The results of the follow‐up on the longitudinal data at 3, 6, and 9 months showed that the renal function indices, potassium and phosphorus levels, and interdialytic weight gain were significantly better than at the pre‐test for the experimental group. Results: In terms of the interaction between group and time, the potassium level dropped significantly below the pre‐test value only after 3 months (B = −0.31, SE = 0.15, p =.044), suggesting that the post‐test potassium level had significantly decreased after 3 months. In terms of the interaction between group and time, the phosphorus level dropped significantly below the pre‐test value only after 6 months (B = −0.53, SE = 0.28, p =.050), suggesting that the post‐test phosphorus level significantly decreased after 6 months. Finally, the intervention could effectively control the weight change between dialysis sessions for up to 9 months (B = −1.34, SE = 0.30, p <.001). Conclusions: The SMP intervention decreased potassium and phosphorus levels and helped control interdialytic weight gain in patients undergoing hemodialysis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence and characteristics of acute kidney injury (AKI) in 100-km ultramarathon runners. Design: Prospective observational study. Setting: The 2011 Soochow University ultramarathon, in which each athlete ran for 100 km. Participants: All Taiwanese entrants who participated in the 100-km race and lived in the northern part of Taiwan were invited to participate in the study. Main Outcome Measures: Acute kidney injury was defined using the Acute Kidney Injury Network criteria. Blood and urine samples were collected 1 week before, immediately after, and 1 day after the race. Results: Immediately after the race, 85% (22) of the 26 subjects were diagnosed with AKI, 65% (16) with moderate dehydration, 23% (6) with muscle cramps, and 12% (3) with hematuria. Body weight was significantly decreased from prerace to all postrace measurements. Plasma levels of potassium ion, creatinine, renin, and aldosterone were significantly elevated immediately after the race and then significantly reduced 1 day after the race. Changes in plasma levels of sodium, creatine kinase, and creatine kinase–MB, as well as urine potassium and creatinine, were indicative of AKI. Conclusions: Transient AKI and muscle cramps are very common in 100-km ultramarathon runners. All transient ultra-runners who developed AKI in this study recovered their renal function 1 day later. Clinical Relevance: Ultramarathon running is associated with a wide range of significant changes in hematological parameters, several of which can be associated with potentially serious renal and physiological abnormalities. [ABSTRACT FROM AUTHOR]