A programme to spread glomerular filtration rate (eGFR) graph surveillance for the early identification, support and treatment of people with progressive chronic kidney disease

A programme to spread eGFR graph surveillance for the early identification, support and treatment of people with progressive chronic kidney disease (ASSIST-CKD): stepped wedge implementation and evaluation of an intervention to reduce late presentation for renal replacement therapy

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN13701669

Enrollment

Registered

2017-01-11

Start date

2015-07-31

Completion date

Unknown

Last updated

2022-01-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic kidney disease Urological and Genital Diseases Chronic kidney disease

Interventions

Reporting of eGFR graphs by pathology laboratories to primary care. The intervention takes the information on pathology computer systems and automatically generates a graph of kidney function over tim

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Patients 65 years with eGFR <40 ml/min/1.73m2

Exclusion criteria

Exclusion criteria: Participants not fulfilling inclusion criteria.

Design outcomes

Primary

Measure	Time frame
Incidence of late presentation for renal replacement therapy, defined as any patient first seen by renal services within 90 days of starting renal replacement therapy. These data will aggregate into six-month time periods, two per calendar year (Jan to June; July to December).	—

Secondary

Measure	Time frame
1. The use of temporary vascular access for starting dialysis 2. Estimated Glomerular Filtration Rate (eGFR) measured within two weeks of start of renal replacement therapy (RRT) 3. Mortality at 6 months from start of RRT in new RRT patients 4. The incident rate of end-stage renal disease, measured annually All outcomes measures are routinely collected by the UK Renal Registry with the exception of vascular access, which is collected annually as part of the Registry’s Multisite Dialysis Access Audit. Routinely collected baseline data will be provided by the UK Renal Registry and baseline referral rates supplied by participating centres. Outcomes will be measured before and during intervention roll-out at each site. The number of new patient referrals (per quarter) will be recorded as a balancing measure. These data are readily extractable from renal centre appointment systems. A qualitative evaluation will also be performed with: 1. Semi-structured interviews with laboratory staff, renal centre staff and service commissioners, in order to find out about the drivers and enablers to the intervention being implemented and also to find out what these groups think the effect of the intervention might be 2. Online survey of GPs receiving the intervention, that is, asking GPs how useful the graph is in identifying people at risk of progressive disease, and how helpful it is in providing education about what to do next 3. Focus groups of primary care staff, where questions will examine in more detail the implementation of the intervention (what happens once the graph arrives in the Practice) and what potential difference the graphs make to patient care	—

Measure

Time frame

1. The use of temporary vascular access for starting dialysis 2. Estimated Glomerular Filtration Rate (eGFR) measured within two weeks of start of renal replacement therapy (RRT) 3. Mortality at 6 months from start of RRT in new RRT patients 4. The incident rate of end-stage renal disease, measured annually All outcomes measures are routinely collected by the UK Renal Registry with the exception of vascular access, which is collected annually as part of the Registry’s Multisite Dialysis Access Audit. Routinely collected baseline data will be provided by the UK Renal Registry and baseline referral rates supplied by participating centres. Outcomes will be measured before and during intervention roll-out at each site. The number of new patient referrals (per quarter) will be recorded as a balancing measure. These data are readily extractable from renal centre appointment systems. A qualitative evaluation will also be performed with: 1. Semi-structured interviews with laboratory staff, renal centre staff and service commissioners, in order to find out about the drivers and enablers to the intervention being implemented and also to find out what these groups think the effect of the intervention might be 2. Online survey of GPs receiving the intervention, that is, asking GPs how useful the graph is in identifying people at risk of progressive disease, and how helpful it is in providing education about what to do next 3. Focus groups of primary care staff, where questions will examine in more detail the implementation of the intervention (what happens once the graph arrives in the Practice) and what potential difference the graphs make to patient care

—

Countries

England, Northern Ireland, Scotland, United Kingdom, Wales

Contacts

Public ContactRowena Sampson

Assist@kidneyresearchuk.org01733 367 834

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 4, 2026