A Lifestyle Intervention to Delay Early Chronic Kidney Disease in African Americans With Diabetic Kidney Disease: Pre-Post Pilot Study. JMIR Form Res 2022 Mar 15;6(3):e34029
Date
03/16/2022Pubmed ID
35289751Pubmed Central ID
PMC8965678DOI
10.2196/34029Scopus ID
2-s2.0-85126485943 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: Behavioral factors, such as lifestyle, have been shown to explain approximately 24% of the excess risk of chronic kidney disease (CKD) among African Americans. However, there are limited intervention studies culturally tailored to African Americans with type 2 diabetes mellitus and CKD.
OBJECTIVE: The main objective of this study was to examine the feasibility and preliminary efficacy of a culturally tailored lifestyle intervention among African Americans with type 2 diabetes mellitus and CKD.
METHODS: A pre-post design was used to test the feasibility of a lifestyle intervention in 30 African American adults recruited from the Medical University of South Carolina between January 2017 and February 2017. A research nurse delivered the manualized study intervention weekly for 6 weeks. Clinical outcomes (hemoglobin A1c, blood pressure, and estimated glomerular filtration rate [eGFR]) were measured at baseline and postintervention. Disease knowledge, self-care, and behavior outcomes were also measured using validated structured questionnaires at baseline and postintervention. Descriptive statistics and effect sizes were calculated to determine clinically important changes from baseline.
RESULTS: Significant pre-post mean differences and decreases were observed for hemoglobin A1c (mean 0.75%, 95% CI 0.16-1.34; P=.01), total cholesterol (mean 16.38 mg/dL, 95% CI 5.82-26.94; P=.004), low-density lipoprotein (mean 13.73 mg/dL, 95% CI 3.91-23.54; P=.008), and eGFR (mean 6.73 mL/min/1.73m2, 95% CI 0.97-12.48; P=.02). Significant pre-post mean differences and increases were observed for CKD self-efficacy (mean -11.15, 95% CI -21.55 to -0.75; P=.03), CKD knowledge (mean -2.62, 95% CI -3.98 to -1.25; P<.001), exercise behavior (mean -1.21, 95% CI -1.96 to -0.46; P=.003), and blood sugar testing (mean -2.15, 95% CI -3.47 to -0.83; P=.003).
CONCLUSIONS: This study provides preliminary data for a large-scale appropriately powered randomized controlled trial to examine a culturally tailored lifestyle intervention in African Americans with type 2 diabetes mellitus and CKD in order to improve clinical, knowledge, self-care, and behavior outcomes in this population.
Author List
Ozieh MN, Egede LEAuthors
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of WisconsinMukoso Nwamaka Ozieh MD Assistant Professor in the Medicine department at Medical College of Wisconsin
