Background: In developing countries, accessibility to specialists, and physician to patient contact time is limited. In\nThailand, A unique community health service is provided by subdistrict health care officers and Village Health\nVolunteers (VHVs). If the personnel were trained on proper chronic kidney disease (CKD) care, CKD progression\nwould be delayed.\nMethods/Design: We conducted a community-based, cluster randomized controlled trial at Kamphaeng Phet\nProvince, located about 400 kilometers north of Bangkok. Two out of eleven districts of the province were randomly\nselected. Approximatly 500 stage 3ââ?¬â??4 CKD patients from 2 districts were enrolled. Patients in both groups will be\ntreated with standard guidelines. The patients in intervention group were provided the additional treatments by\nmultidisciplinary team in conjunction with community CKD care network (subdistrict health care officers and VHVs)\nwhich will provide group counseling during each hospital visit and quarterly home visits to monitor dietary protein\nand sodium intake, blood pressure measurement and drug compliance. Duration of the study is 2 years. The\nprimary outcome is the difference of rate of eGFR decline. The secondary outcomes are laboratory parameters and\nincidence of clinical endpoints such as mortality rate and cardiovascular events, end-stage renal disease (ESRD), etc.\nInsights of this study may set forth a new standard of community-based CKD care.
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