Chronic Kidney Disease
Conditions
Keywords
Chronic Kidney disease, Nephrologists, Primary Care, Death, Renal Replacement Therapy, Specialised renal care
Brief summary
This is a prospective randomised trial studying patients with stage 3 to 5 chronic kidney disease (CKD) in order to determine the impact of specialised care by nephrologists compared to guidelines-directed management by primary care physicians (PCP) on: a) prognosis (clinical outcome), b) planning of renal replacement therapy (RRT) (urgent versus planned initiation RRT) and c) patient satisfaction.
Interventions
BEHAVIORALspecialised renal care
* Combined management PCP - nephrologists (at least 4 nephrology visits/year). Agreement of the PCP is required for this combined management. * Management by PCPs only, with the help of written instructions from our nephrology unit based on EBPG. Requested Email or over the phone advices to PCPs will be provided by the nephrology division of HUG.
Sponsors
Schweizerische Nierenliga
Patrick Saudan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients with CKD stage 3, 4 and 5 (CCl \< 40 ml/min according to abbreviated MDRD formula) aged 18-80 years old and enrolled during a hospitalization.
Exclusion criteria
* Patients previously known by nephrologists. * Estimated life expectancy \< 1 year * Refusal or inability to sign writing consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary (composite): death, and hospitalisation | 24 months after enrollment | death and emergency hospitalisation during the following 2 years afterr andomisation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Secondary: initiation of urgent RRT, decline of renal residual function at 2 years, decline of quality of life | 24 months after enrollment | cf title |
Countries
Switzerland
Outcome results
None listed