Evaluation of a Multidisciplinary Care Pathway on the Evolution of Renal Function in Patients With Advanced Chronic Kidney Disease

NCT ID: NCT06495385

Last Updated: 2024-07-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Total Enrollment

535 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-04-09

Study Completion Date

2024-09-30

Brief Summary

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The number of incident and prevalent patients with end stage renal disease on dialysis treatment is increasing in France and worldwide. A quarter of dialysis patients are initiating dialysis urgently through central venous catheters and the number of patients registered in the waiting list for renal transplantation before dialysis initiation is very low. This is also reflected in the very low number of pre-emptive renal transplantations.

In order to reduce the number of dialysis patients, the French state has induced a national program proposing a multidisciplinary care pathway including the nephrology visits and at least one consultation with a dietitian and a specialist renal nurse in all patients with Chronic Kidney Disease stage 4 and 5.

Detailed Description

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The aim of this single-center retrospective study is to evaluate the influence of the complete, partial or no participation in this program on the evolution of renal function and clinicobiological parameters in this group of patients.

Conditions

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Chronic Kidney Disease stage4 Chronic Kidney Disease Stage 5

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Study group

Full participation (medical + dietitian+ specialist nurse)

Evolution of renal function

Intervention Type DIAGNOSTIC_TEST

Plasma creatinine levels and glomerular filtration rate estimated using the CKD-Epi formula adjusted for 1.73 m2 body surface area will be measured.

Measurement of haemoglobin levels

Intervention Type DIAGNOSTIC_TEST

Haemoglobin levels will be measured.

Measurement of biological parameters

Intervention Type DIAGNOSTIC_TEST

Plasma levels of urea, calcium, phosphorus and parathyroid hormone, as well as alkaline reserve, will be measured.

Measure sodium and protein consumption

Intervention Type DIAGNOSTIC_TEST

24-hour urine volume, proteinuria, urea and sodium, will be measured.

Quality of life questionnaire EUROQOL 5 dimensions (EQ-5D-5L)

Intervention Type BEHAVIORAL

The descriptive system comprises five dimensions: mobility, personal care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, mild problems, moderate problems, severe problems and extreme problems. The figures for the five dimensions can be combined into a 5-digit number describing the patient's state of health. Scores close to 1 indicate "the best health you can imagine" and those close to 0 "the worst health you can imagine".

Control 1

Partial participation (medical+ dietitian OR specialist nurse)

Evolution of renal function

Intervention Type DIAGNOSTIC_TEST

Plasma creatinine levels and glomerular filtration rate estimated using the CKD-Epi formula adjusted for 1.73 m2 body surface area will be measured.

Measurement of haemoglobin levels

Intervention Type DIAGNOSTIC_TEST

Haemoglobin levels will be measured.

Measurement of biological parameters

Intervention Type DIAGNOSTIC_TEST

Plasma levels of urea, calcium, phosphorus and parathyroid hormone, as well as alkaline reserve, will be measured.

Measure sodium and protein consumption

Intervention Type DIAGNOSTIC_TEST

24-hour urine volume, proteinuria, urea and sodium, will be measured.

Quality of life questionnaire EUROQOL 5 dimensions (EQ-5D-5L)

Intervention Type BEHAVIORAL

The descriptive system comprises five dimensions: mobility, personal care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, mild problems, moderate problems, severe problems and extreme problems. The figures for the five dimensions can be combined into a 5-digit number describing the patient's state of health. Scores close to 1 indicate "the best health you can imagine" and those close to 0 "the worst health you can imagine".

Control 2

No participation (medical visit only)

Evolution of renal function

Intervention Type DIAGNOSTIC_TEST

Plasma creatinine levels and glomerular filtration rate estimated using the CKD-Epi formula adjusted for 1.73 m2 body surface area will be measured.

Measurement of haemoglobin levels

Intervention Type DIAGNOSTIC_TEST

Haemoglobin levels will be measured.

Measurement of biological parameters

Intervention Type DIAGNOSTIC_TEST

Plasma levels of urea, calcium, phosphorus and parathyroid hormone, as well as alkaline reserve, will be measured.

Measure sodium and protein consumption

Intervention Type DIAGNOSTIC_TEST

24-hour urine volume, proteinuria, urea and sodium, will be measured.

Quality of life questionnaire EUROQOL 5 dimensions (EQ-5D-5L)

Intervention Type BEHAVIORAL

The descriptive system comprises five dimensions: mobility, personal care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, mild problems, moderate problems, severe problems and extreme problems. The figures for the five dimensions can be combined into a 5-digit number describing the patient's state of health. Scores close to 1 indicate "the best health you can imagine" and those close to 0 "the worst health you can imagine".

Interventions

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Evolution of renal function

Plasma creatinine levels and glomerular filtration rate estimated using the CKD-Epi formula adjusted for 1.73 m2 body surface area will be measured.

Intervention Type DIAGNOSTIC_TEST

Measurement of haemoglobin levels

Haemoglobin levels will be measured.

Intervention Type DIAGNOSTIC_TEST

Measurement of biological parameters

Plasma levels of urea, calcium, phosphorus and parathyroid hormone, as well as alkaline reserve, will be measured.

Intervention Type DIAGNOSTIC_TEST

Measure sodium and protein consumption

24-hour urine volume, proteinuria, urea and sodium, will be measured.

Intervention Type DIAGNOSTIC_TEST

Quality of life questionnaire EUROQOL 5 dimensions (EQ-5D-5L)

The descriptive system comprises five dimensions: mobility, personal care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, mild problems, moderate problems, severe problems and extreme problems. The figures for the five dimensions can be combined into a 5-digit number describing the patient's state of health. Scores close to 1 indicate "the best health you can imagine" and those close to 0 "the worst health you can imagine".

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* All stage 4 and 5 Chronic Kidney Disease patients that were included in the program from 01/01/2021 to 31/12/2021 in the clinics of AURA SANTE

Exclusion Criteria

* Patients without a medical follow up during this year (2021)
* Patients with insufficient or no data during the 24 month of follow up period
* Active treatment with corticosteroids, cytotoxic or immunosuppressive drugs, ongoing infection, autoimmune disease or active tumor process.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Universitaire de Saint Etienne

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hélène PAGES, nurse

Role: PRINCIPAL_INVESTIGATOR

CHU de Saint-Etienne

Locations

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AURA Santé

Chamalières, , France

Site Status

Countries

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France

Other Identifiers

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IRBN1502023/CHUSTE

Identifier Type: -

Identifier Source: org_study_id

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