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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Name of Arm 1: Study group | Description: Full participation (medical + dietitian+ specialist nurse) |
| |
| Name of Arm 2: Control 1 | Description: Partial participation (medical+ dietitian OR specialist nurse) |
| |
| Name of Arm 3: Control 2 | Description: No participation (medical visit only) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GFR | Diagnostic Test | Exit of the study due to death, dialysis, or transplantation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Glomerular filtration rate | The estimated Glomerular filtration rate is estimated with the CKD-EPI formula adjusted for 1.73m2 of body surface area and produced in ml/min/1.73m2 of body surface area | Every 6 months for 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Patients survival rate | Number of deaths during the sudy period | Every 6 months for 24 months |
| Renal survival rate | Number of patients initiating dialysis during the study period |
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Inclusion Criteria:
Exclusion Criteria:
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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
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hélène PAGES | Contact | 07 56 05 21 24 | h.pages@aurasante.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Aura Sante | Recruiting | Chamalières | Auvergne | 63400 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41145944 | Derived | Pages H, Kosmadakis G, Kanouni FE, Necoara A, Baudenon J, Deville C, Enache I, Murat-Ringot A, Verot E. Evaluation of multidisciplinary care pathways on kidney function in patients with advanced chronic kidney disease: multicenter study. J Nephrol. 2025 Dec;38(9):2775-2784. doi: 10.1007/s40620-025-02365-8. Epub 2025 Oct 27. |
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The chief investigator is going solely to include and analyse data without sharing them with anybody else
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|
| Every 6 months for 24 months |
| Haemoglobin levels | Evolution of haemoglobin levels during the study period in gram/dL | Every 6 months for 24 months |
| Plasma Calcium levels | Evolution of plasma calcium levels during the study period in mg/dL | Every 6 months for 24 months |
| Plasma Phosphate levels | Evolution of plasma phosphate levels during the study period in mg/dL | Every 6 months for 24 months |
| Plasma parathyroid hormone levels | Evolution of plasma parathyroid hormone levels during the study period in pg/ml | Every 6 months for 24 months |
| Plasma alcaline reserve levels | Evolution of plasma alcaline reserve levels during the study period in mmol/l | Every 6 months for 24 months |
| 24h salt consumption | Evolution of salt consumption during the study period in g/24h | Every 6 months for 24 months |
| 24h protein consumption | Evolution of protein consumption during the study period in g/24h | Every 6 months for 24 months |
| Quality of life score | Scores from Evaluation Quality of life,5 dimensions, 5 levels (EQ-5D-5L), the higher the score the better the outcome | through study completion, an average of 6 months |