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- Title
Risk profile, quality of life and care of patients with moderate and advanced CKD: The French CKD-REIN Cohort Study.
- Authors
Stengel, Bénédicte; Metzger, Marie; Combe, Christian; Jacquelinet, Christian; Briançon, Serge; Ayav, Carole; Fouque, Denis; Laville, Maurice; Frimat, Luc; Pascal, Christophe; Herpe, Yves-Edouard; Morel, Pascal; Deleuze, Jean-François; Schanstra, Joost P; Lange, Céline; Legrand, Karine; Speyer, Elodie; Liabeuf, Sophie; Robinson, Bruce M; Massy, Ziad A
- Abstract
Background The French Chronic Kidney Disease–Renal Epidemiology and Information Network (CKD-REIN) cohort study was designed to investigate the determinants of prognosis and care of patients referred to nephrologists with moderate and advanced chronic kidney disease (CKD). We examined their baseline risk profile and experience. Methods We collected bioclinical and patient-reported information from 3033 outpatients with CKD and estimated glomerular filtration rates (eGFRs) of 15–60 mL/min/1.73 m2 treated at 40 nationally representative public and private facilities. Results The patients' median age was 69 (60–76) years, 65% were men, their mean eGFR was 33 mL/min/1.73 m2, 43% had diabetes, 24% had a history of acute kidney injury (AKI) and 57% had uncontrolled blood pressure (BP; >140/90 mmHg). Men had worse risk profiles than women and were more likely to be past or current smokers (73% versus 34%) and have cardiovascular disease (59% versus 42%), albuminuria >30 mg/mmol (or proteinuria > 50) (40% versus 30%) (all P < 0.001) and a higher median risk of end-stage renal disease within 5 years, predicted by the kidney failure risk equation {12% [interquartile range (IQR) 3–37%] versus 9% [3–31%], P = 0.008}. During the previous year, 60% of patients reported one-to-two nephrologist visits and four or more general practitioner visits; only 25% saw a dietician and 75% were prescribed five or more medications daily. Physical and mental quality of life (QoL) were poor, with scores <50/100. Conclusions The CKD-REIN study highlights high-risk profiles of cohort members and identifies several priorities, including improving BP control and dietary counselling and increasing doctors' awareness of AKI, polypharmacy and QoL. Trial registration ClinicalTrials.gov identifier: NCT03381950
- Subjects
CHRONIC kidney failure; KIDNEY failure; NEPHROLOGISTS; KIDNEY diseases; GLOMERULAR filtration rate; QUALITY of life
- Publication
Nephrology Dialysis Transplantation, 2019, Vol 34, Issue 2, p277
- ISSN
0931-0509
- Publication type
Article
- DOI
10.1093/ndt/gfy058