Impact of Predialysis Therapeutic Practices on Patient Outcomes During the First Year of Dialysis

Thilly, Nathalie; Boini, Stéphanie; Loos-Ayav, Carole; Kessler, Michèle; Briançon, Serge; Frimat, Luc

doi:10.1097/mlr.0b013e3181d56926

Cited by 12 publications

(8 citation statements)

References 25 publications

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“…In a cohort study of 556 patients initiating dialysis, receipt of quality care in the management of CKD-related complications prior to dialysis initiation was associated with greater survival during the first year following dialysis initiation [10]. To improve the recognition and facilitate management of patients with CKD, the National Kidney Foundation (NKF) developed the Kidney Disease Outcomes Quality Initiative (KDOQI).…”

Section: Introductionmentioning

confidence: 99%

Perceptions and use of the national kidney foundation KDOQI guidelines: a survey of U.S. renal healthcare providers

et al. 2013

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BackgroundThe National Kidney Foundation (NKF) Kidney Disease Outcomes Quality Initiative (KDOQI) developed guidelines to care for patients with chronic kidney disease (CKD). While these are disseminated through the NKF’s website and publications, the guidelines’ usage remains suboptimal. The KDOQI Educational Committee was formed to identify barriers to guideline implementation, determine provider and patient educational needs and develop tools to improve care of patients with CKD.MethodsAn online survey was conducted from May to September 2010 to evaluate renal providers’ familiarity, current use of and attitudes toward the guidelines and tools to implement the guidelines.ResultsMost responders reported using the guidelines often and felt that they could be easily implemented into clinical practice; however, approximately one-half identified at least one barrier. Physicians and physician extenders most commonly cited the lack of evidence supporting KDOQI guidelines while allied health professionals most commonly listed patient non-adherence, unrealistic guideline goals and provider time-constraints. Providers thought that the guidelines included too much detail and identified the lack of a quick resource as a barrier to clinical implementation. Most were unaware of the Clinical Action Plans.ConclusionsPerceived barriers differed between renal clinicians and allied health professionals; educational and implementation tools tailored for different providers are needed.

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Section: Introductionmentioning

confidence: 99%

Perceptions and use of the national kidney foundation KDOQI guidelines: a survey of U.S. renal healthcare providers

et al. 2013

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“…In particular, the relationship between quality of pre-dialysis care and HRQoL at dialysis onset has not been investigated to date. However, numerous studies have shown associations between quality of pre-dialysis care and dialysis mortality on one hand [4] and, HRQoL at dialysis onset and dialysis mortality on the other hand [5-7]. …”

Section: Introductionmentioning

confidence: 99%

“…Moreover, a favourable association between early referral or a high number of pre-ESRD nephrology consultations and quality of therapeutic care has been suggested [11,12]. Likewise, quality of pre-ESRD therapeutic practices has been found to be associated with survival after RRT [4]. …”

Section: Introductionmentioning

confidence: 99%

Predialysis therapeutic care and health-related quality of life at dialysis onset (The pharmacoepidemiologic AVENIR study)

Boini

Frimat

Kessler

et al. 2011

Health and Quality of Life Outcomes

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BackgroundTo determine the impact of the quality of pre-dialysis nephrological care on health-related quality of life (HRQoL) at dialysis onset, which has not been well evaluated.MethodsAll adults who began a dialysis treatment in the administrative region of Lorraine (France) in 2005 or 2006, were enrolled in this prospective observational study.HRQoL was measured using the Kidney Disease Quality of Life V36 questionnaire, which enables calculation of two generic (physical and mental) and three specific dimensions (Symptoms/problems, Effects and Burden of kidney disease). The specific dimensions were scored from 0 to 100 (worst to best possible functioning). Pre-dialysis nephrological care was measured using three indicators: quality of therapeutic practices (evaluated across five main aspects: hypertension/proteinuria, anemia, bone disease, metabolic acidosis and dyslipidemia), time since referral to a nephrologist and number of nephrology consultations in the year preceding dialysis treatment.ResultsTwo thousand and eighty-three (67.4%) patients were referred to a nephrologist more than 1 month before dialysis initiation and completed the HRQoL questionnaire. Quality of therapeutic practices was significantly associated with the Mental component. Time since referral to a nephrologist was associated with Symptoms/problems and the Effects of kidney disease dimensions, but no relationship was found between the number of nephrology consultations and HRQoL.ConclusionsHRQoL at dialysis onset is significantly influenced by the quality of pre-dialysis nephrological care. Therefore, disease management should be emphasized.

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“…This finding is in accordance with those of a prospective French study, which showed that the quality of CKD care was independently associated with better early survival on dialysis. 11 In addition, it matches with the positive impact of multidisciplinary care on some patients' early outcomes. 12 Early mortality in dialysis has multiple causes ( Figure 1).…”

mentioning

confidence: 68%

Early mortality in dialysis and adequacy of predialysis renal care: the picture is more complex than we thought

Rognant¹,

Laville²

2014

Kidney International

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Two new studies examine clinical events during early dialysis. Foley et al. underline a probable ascertainment bias affecting the mortality rate during the first 6 weeks and find that age is the major risk factor for very early mortality, which can be amplified by short time of predialysis nephrology care. Singhal et al. show that adequacy of predialysis renal care is determined not only by the timing of the nephrology referral but also by the number and timing of visits.

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Impact of Predialysis Therapeutic Practices on Patient Outcomes During the First Year of Dialysis

Abstract: This study suggests that quality of predialysis therapeutic practices is positively associated with survival during the first year of dialysis.

Cited by 12 publications

References 25 publications

Perceptions and use of the national kidney foundation KDOQI guidelines: a survey of U.S. renal healthcare providers

Perceptions and use of the national kidney foundation KDOQI guidelines: a survey of U.S. renal healthcare providers

Predialysis therapeutic care and health-related quality of life at dialysis onset (The pharmacoepidemiologic AVENIR study)

Early mortality in dialysis and adequacy of predialysis renal care: the picture is more complex than we thought

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