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Pre-dialysis care trajectory and post-dialysis survival and transplantation access in patients with end-stage kidney disease

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Abstract

Background

The pre-dialysis care trajectory impact on post-dialysis outcomes is poorly known. This study assessed survival, access to kidney transplant waiting list and to transplantation after dialysis initiation by taking into account the patients’ pre-dialysis care consumption (inpatient and outpatient) and the conditions of dialysis start: initiation context (emergency or planned) and vascular access type (catheter or fistula).

Methods

Adults who started dialysis in France in 2015 were included. Clinical data came from the French REIN registry and data on the care trajectory from the French National Health Data system (SNDS). The Cox model was used to assess survival and access to kidney transplantation.

Results

We included 8856 patients with a mean age of 68 years. Survival was shorter in patients with emergency or planned dialysis initiation with a catheter compared to patients with planned dialysis with a fistula. The risk of death was lower in patients who were seen by a nephrologist more than once in the 6 months before dialysis than in those who were seen only once. The rate of kidney transplant at 1 year post-dialysis was lower for patients with emergency or planned dialysis initiation with a catheter (respectively, HR = 0.5 [0.4; 0.8] and HR = 0.7 [0.5; 0.9]) compared to patients with planned dialysis start with a fistula. Patients who were seen by a nephrologist more than three times between 0 and 6 months before dialysis start were more likely to access the waiting list 1 and 3 years after dialysis start (respectively, HR = 1.3 [1.1; 1.5] and HR = 1.2 [1.1; 1.4]).

Conclusions

Nephrological follow-up in the year before dialysis initiation is associated with better survival and higher probability of access to kidney transplantation. These results emphasize the importance of early patient referral to nephrologists by general practitioners.

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Data availability

Access to the data of the REIN registry implies the approval by the REIN scientific board which analyzes each request. Information about the data of the REIN registry can be requested by mail to Dr. Cécile Couchoud who manages the REIN registry at the French Biomedicine Agency (cecile.couchoud@biomedecine.fr).

References

  1. Guide parcours de soins maladie rénale chronique de l’adulte [Internet]. Haute Autorité de Santé. Available from: https://www.has-sante.fr/jcms/c_1241102/fr/guide-parcours-de-soins-maladie-renale-chronique-de-l-adulte. Accessed 27 Aug 2021

  2. Lameire NH, Levin A, Kellum JA, Cheung M, Jadoul M, Winkelmayer WC et al (2021) Harmonizing acute and chronic kidney disease definition and classification: report of a kidney disease: improving global outcomes (KDIGO) consensus conference. Kidney Int 100(3):516–526

    PubMed  Google Scholar 

  3. Johansen KL, Chertow GM, Foley RN, Gilbertson DT, Herzog CA, Ishani A et al (2021) US renal data system 2020 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 77(4 Suppl 1):A7

    PubMed  PubMed Central  Google Scholar 

  4. Pippias M, Jager KJ, Kramer A, Leivestad T, Sánchez MB, Caskey FJ et al (2016) The changing trends and outcomes in renal replacement therapy: data from the ERA-EDTA registry. Nephrol Dial Transplant 31(5):831–841

    PubMed  Google Scholar 

  5. Rapport_rein_2019_2021–10–14.pdf [Internet]. Available from: https://www.agence-biomedecine.fr/IMG/pdf/rapport_rein_2019_2021-10-14.pdf. Accessed 4 May 2022

  6. Tonelli M, Wiebe N, Manns BJ, Klarenbach SW, James MT, Ravani P et al (2018) Comparison of the complexity of patients seen by different medical subspecialists in a Universal Health Care System. JAMA Netw Open 1(7):e184852

    PubMed  PubMed Central  Google Scholar 

  7. Guide_remplissage_diadem_2017_version_finale.pdf [Internet]. Available from: https://www.agence-biomedecine.fr/IMG/pdf/guide_remplissage_diadem_2017_version_finale.pdf. Accessed 14 Sept 2021

  8. Weckmann GFC, Stracke S, Haase A, Spallek J, Ludwig F, Angelow A et al (2018) Diagnosis and management of non-dialysis chronic kidney disease in ambulatory care: a systematic review of clinical practice guidelines. BMC Nephrol 11(19):258

    Google Scholar 

  9. Mendelssohn DC, Malmberg C, Hamandi B (2009) An integrated review of ‘unplanned’ dialysis initiation: reframing the terminology to ‘suboptimal’ initiation. BMC Nephrol 12(10):22

    Google Scholar 

  10. Hassan R, Akbari A, Brown PA, Hiremath S, Brimble KS, Molnar AO (2019) Risk factors for unplanned dialysis initiation: a systematic review of the literature. Can J Kidney Health Dis 6:2054358119831684

    PubMed  PubMed Central  Google Scholar 

  11. Park JI, Kim M, Kim H, An JN, Lee J, Yang SH et al (2015) Not early referral but planned dialysis improves quality of life and depression in newly diagnosed end stage renal disease patients: a prospective cohort study in Korea. PLoS ONE 10(2):e0117582

    PubMed  PubMed Central  Google Scholar 

  12. Panocchia N, Tazza L, Di Stasio E, Liberatori M, Vulpio C, Giungi S et al (2016) Mortality in hospitalized chronic kidney disease patients starting unplanned urgent haemodialysis. Nephrology (Carlton) 21(1):62–67

    PubMed  Google Scholar 

  13. Chen YM, Wang YC, Hwang SJ, Lin SH, Wu KD (2016) Patterns of dialysis initiation affect outcomes of incident hemodialysis patients. Nephron 132(1):33–42

    CAS  PubMed  Google Scholar 

  14. Michel A, Pladys A, Bayat S, Couchoud C, Hannedouche T, Vigneau C (2018) Deleterious effects of dialysis emergency start, insights from the French REIN registry. BMC Nephrol 19(1):233

    PubMed  Google Scholar 

  15. Brown PA, Akbari A, Molnar AO, Taran S, Bissonnette J, Sood M et al (2015) Factors associated with unplanned dialysis starts in patients followed by nephrologists: a retropective cohort Study. PLoS ONE 10(6):e0130080

    PubMed  PubMed Central  Google Scholar 

  16. Descamps C, Labeeuw M, Trolliet P, Cahen R, Ecochard R, Pouteil-Noble C et al (2011) Confounding factors for early death in incident end-stage renal disease patients: role of emergency dialysis start. Hemodial Int 15(1):23–29

    PubMed  Google Scholar 

  17. Xue H, Ix JH, Wang W, Sm B, Lazarus M, Hakim R et al (2013) Hemodialysis access usage patterns in the incident dialysis year and associated catheter-related complications. Am J Kidney Dis 61(1):123

    PubMed  Google Scholar 

  18. Ravani P, Palmer SC, Oliver MJ, Quinn RR, MacRae JM, Tai DJ et al (2013) Associations between hemodialysis access type and clinical outcomes: a systematic review. J Am Soc Nephrol 24(3):465–473

    PubMed  PubMed Central  Google Scholar 

  19. Raithatha A, McKane W, Kendray D, Evans C (2010) Catheter access for hemodialysis defines higher mortality in late-presenting dialysis patients. Ren Fail 32(10):1183–1188

    PubMed  Google Scholar 

  20. de Jager DJ, Voormolen N, Krediet RT, Dekker FW, Boeschoten EW, Grootendorst DC et al (2011) Association between time of referral and survival in the first year of dialysis in diabetics and the elderly. Nephrol Dial Transplant 26(2):652–658

    PubMed  Google Scholar 

  21. Winkelmayer WC, Owen WF, Levin R, Avorn J (2003) A propensity analysis of late versus early nephrologist referral and mortality on dialysis. J Am Soc Nephrol 14(2):486–492

    PubMed  Google Scholar 

  22. Kazmi WH, Obrador GT, Khan SS, Pereira BJG, Kausz AT (2004) Late nephrology referral and mortality among patients with end-stage renal disease: a propensity score analysis. Nephrol Dial Transplant 19(7):1808–1814

    PubMed  Google Scholar 

  23. Stack AG (2003) Impact of timing of nephrology referral and pre-ESRD care on mortality risk among new ESRD patients in the United States. Am J Kidney Dis 41(2):310–318

    PubMed  Google Scholar 

  24. Iwata Y, Okushima H, Takatsuka T, Yoshimura D, Kawamura T, Iio R et al (2020) Duration of predialysis nephrological care and mortality after dialysis initiation. Clin Exp Nephrol 24(8):705–714

    PubMed  Google Scholar 

  25. Singhal R, Hux JE, Alibhai SMH, Oliver MJ (2014) Inadequate predialysis care and mortality after initiation of renal replacement therapy. Kidney Int 86(2):399–406

    PubMed  Google Scholar 

  26. Smart NA, Dieberg G, Ladhani M, Titus T (2014) Early referral to specialist nephrology services for preventing the progression to end-stage kidney disease. Cochrane Database Syst Rev 18(6):CD007333

    Google Scholar 

  27. Kim DH, Kim M, Kim H, Kim YL, Kang SW, Yang CW et al (2013) Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea. PLoS ONE 8(1):e55323

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Lu JL, Molnar MZ, Sumida K, Diskin CD, Streja E, Siddiqui OA et al (2018) Association of the frequency of pre-end-stage renal disease medical care with post-end-stage renal disease mortality and hospitalization. Nephrol Dial Transplant 33(5):789–795

    PubMed  Google Scholar 

  29. Pisoni RL, Arrington CJ, Albert JM, Ethier J, Kimata N, Krishnan M et al (2009) Facility hemodialysis vascular access use and mortality in countries participating in DOPPS: an instrumental variable analysis. Am J Kidney Dis 53(3):475–491

    PubMed  Google Scholar 

  30. Couchoud C, Stengel B, Landais P, Aldigier JC, de Cornelissen F, Dabot C et al (2006) The renal epidemiology and information network (REIN): a new registry for end-stage renal disease in France. Nephrol Dial Transplant 21(2):411–418

    PubMed  Google Scholar 

  31. Raffray M, Bayat S, Lassalle M, Couchoud C (2020) Linking disease registries and nationwide healthcare administrative databases: the French renal epidemiology and information network (REIN) insight. BMC Nephrol 21(1):25

    PubMed  PubMed Central  Google Scholar 

  32. Raffray M, Vigneau C, Couchoud C, Bayat S (2021) Predialysis care trajectories of patients with ESKD starting dialysis in emergency in France. Kidney Int Rep 6(1):156–167

    PubMed  Google Scholar 

  33. Sterne JAC, White IR, Carlin JB, Spratt M, Royston P, Kenward MG et al (2009) Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ 338(jun29 1):b2393

    PubMed  PubMed Central  Google Scholar 

  34. Andersen PK, Geskus RB, de Witte T, Putter H (2012) Competing risks in epidemiology: possibilities and pitfalls. Int J Epidemiol 41(3):861–870

    PubMed  PubMed Central  Google Scholar 

  35. Noordzij M, Leffondré K, van Stralen KJ, Zoccali C, Dekker FW, Jager KJ (2013) When do we need competing risks methods for survival analysis in nephrology? Nephrol Dial Transplant 28(11):2670–2677

    PubMed  Google Scholar 

  36. Wolbers M, Koller MT, Stel VS, Schaer B, Jager KJ, Leffondré K et al (2014) Competing risks analyses: objectives and approaches. Eur Heart J 35(42):2936–2941

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Marrón B, Ortiz A, de Sequera P, Martín-Reyes G, de Arriba G, Lamas JM et al (2006) Impact of end-stage renal disease care in planned dialysis start and type of renal replacement therapy–a Spanish multicentre experience. Nephrol Dial Transplant 21(Suppl 2):ii51-55

    PubMed  Google Scholar 

  38. Cho EJ, Park HC, Yoon HB, Ju KD, Kim H, Oh YK et al (2012) Effect of multidisciplinary pre-dialysis education in advanced chronic kidney disease: propensity score matched cohort analysis. Nephrology (Carlton) 17(5):472–479

    PubMed  Google Scholar 

  39. Chiu K, Alam A, Iqbal S (2012) Predictors of suboptimal and crash initiation of dialysis at two tertiary care centers. Hemodial Int 16(Suppl 1):S39-46

    PubMed  Google Scholar 

  40. Gomis Couto A, Teruel Briones JL, Fernández Lucas M, Rivera Gorrin M, Rodríguez Mendiola N, Jiménez Álvaro S et al (2011) Causes of unplanned hemodialysis initiation. Nefrologia 31(6):733–737

    CAS  PubMed  Google Scholar 

  41. Kanno A, Nakayama M, Sanada S, Sato M, Sato T, Taguma Y (2019) Suboptimal initiation predicts short-term prognosis and vulnerability among very elderly patients who start haemodialysis. Nephrology (Carlton) 24(1):94–101

    PubMed  Google Scholar 

  42. Metcalfe W, Khan IH, Prescott GJ, Simpson K, MacLeod AM (2000) Can we improve early mortality in patients receiving renal replacement therapy? Kidney Int 57(6):2539–2545

    CAS  PubMed  Google Scholar 

  43. Frimat L, Loos-Ayav C, Panescu V, Cordebar N, Briançon S, Kessler M (2004) Early referral to a nephrologist is associated with better outcomes in type 2 diabetes patients with end-stage renal disease. Diabetes Metab 30(1):67–74

    CAS  PubMed  Google Scholar 

  44. Yoon HE, Chung S, Chung HW, Shin MJ, Lee SJ, Kim YS et al (2009) Status of initiating pattern of hemodialysis: a multi-center study. J Korean Med Sci 24(Suppl):S102-108

    PubMed  PubMed Central  Google Scholar 

  45. Teo BW, Ma V, Xu H, Li J, Lee EJ, Nephrology Clinical Research Group (2010) Profile of hospitalisation and death in the first year after diagnosis of end-stage renal disease in a multi-ethnic Asian population. Ann Acad Med Singapore 39(2):79–87

    PubMed  Google Scholar 

  46. Béchade C, Dejardin O, Bara S, Bouvier V, Guizard AV, De Mil R et al (2018) Incidence and characteristics of chronic renal replacement therapy in patients with cancer: data from kidney and cancer registries in Basse-Normandie. J Nephrol 31(1):111–118

    PubMed  Google Scholar 

  47. Buck J, Baker R, Cannaby AM, Nicholson S, Peters J, Warwick G (2007) Why do patients known to renal services still undergo urgent dialysis initiation? A cross-sectional survey. Nephrol Dial Transplant 22(11):3240–3245

    PubMed  Google Scholar 

  48. Crews DC, Jaar BG, Plantinga LC, Kassem HS, Fink NE, Powe NR (2010) Inpatient hemodialysis initiation: reasons, risk factors and outcomes. Nephron Clin Pract 114(1):c19-28

    PubMed  Google Scholar 

  49. Hughes SA, Mendelssohn JG, Tobe SW, McFarlane PA, Mendelssohn DC (2013) Factors associated with suboptimal initiation of dialysis despite early nephrologist referral. Nephrol Dial Transplant 28(2):392–397

    PubMed  Google Scholar 

  50. Piwko C, Vicente C, Marra L, Jivraj F, Appel E, Wolpin J et al (2012) The STARRT trial: a cost comparison of optimal vs sub-optimal initiation of dialysis in Canada. J Med Econ 15(1):96–104

    PubMed  Google Scholar 

  51. Nadeau-Fredette AC, Tennankore KK, Kim SJ, Chan CT (2013) Suboptimal initiation of home hemodialysis: determinants and clinical outcomes. Nephron Clin Pract 124(1–2):132–140

    PubMed  Google Scholar 

  52. Chantrel F (2010) Démarrage d’un traitement par dialyse chronique en urgence. Quels patients? Quelles conséquences? BEH thématique (9–10):81–86

  53. Alizada U, Sauleau EA, Krummel T, Moranne O, Kazes I, Couchoud C et al (2021) Effect of emergency start and central venous catheter on outcomes in incident hemodialysis patients: a prospective observational cohort. J Nephrol. https://doi.org/10.1007/s40620-021-01188-7

    Article  PubMed  Google Scholar 

  54. Filc D, Davidovich N, Novack L, Balicer RD (2014) Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system? Int J Equity Health. https://doi.org/10.1186/s12939-014-0115-1

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kasiske BL, London W, Ellison MD (1998) Race and socioeconomic factors influencing early placement on the kidney transplant waiting list. J Am Soc Nephrol 9(11):2142

    CAS  PubMed  Google Scholar 

  56. Zhang Y, Gerdtham UG, Rydell H, Jarl J (2018) Socioeconomic inequalities in the kidney transplantation process: a registry-based study in Sweden. Transplant Direct 4(2):e346

    PubMed  PubMed Central  Google Scholar 

  57. Pruthi R, Robb ML, Oniscu GC, Tomson C, Bradley A, Forsythe JL et al (2020) Inequity in access to transplantation in the United Kingdom. Clin J Am Soc Nephrol 15(6):830

    PubMed  PubMed Central  Google Scholar 

  58. Calvar E, Launay L, Bayat-Makoei S, Bauwens M, Lassalle M, Couchoud C et al (2023) Social deprivation reduced registration for kidney transplantation through markers of nephrological care: a mediation analysis. J Clin Epidemiol 10(157):92–101

    Google Scholar 

  59. Boonstra MD, Reijneveld SA, Foitzik EM, Westerhuis R, Navis G, de Winter AF (2020) How to tackle health literacy problems in chronic kidney disease patients? A systematic review to identify promising intervention targets and strategies. Nephrol Dial Transplant 36(7):1207–1221

    PubMed  PubMed Central  Google Scholar 

  60. Taylor DM, Fraser SDS, Bradley JA, Bradley C, Draper H, Metcalfe W et al (2017) A Systematic review of the prevalence and associations of limited health literacy in CKD. Clin J Am Soc Nephrol 12(7):1070–1084

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to thank all people involved in the REIN registry (nephrologists, epidemiologists, clinical research associates, and data managers). The list of centers that participate in the REIN registry is available in the 2019 annual REIN report (https://www.agence-biomedecine.fr/IMG/pdf/rapport_rein_2019_2021-10-14.pdf).

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Authors and Affiliations

  1. Univ Rennes, EHESP, CNRS, Inserm, Arènes – UMR 6051, RSMS – U1309, French School of Public Health, 15 Avenue du Professeur Léon Bernard, Rennes, France

    Juliette Piveteau, Maxime Raffray & Sahar Bayat

  2. Renal Epidemiology and Information Network (REIN) Registry, Biomedecine Agency, Saint-Denis-La-Plaine, France

    Cécile Couchoud

  3. CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France

    Carole Ayav

  4. Centre Universitaire des Maladies Rénales, CHU Caen, Caen, France

    Valérie Chatelet

  5. U1086 Inserm, ANTICIPE, Centre de Lutte Contre le Cancer François Baclesse, Caen, France

    Valérie Chatelet

  6. Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) – UMR_S 1085, Rennes, France

    Cécile Vigneau

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  1. Juliette Piveteau
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  2. Maxime Raffray
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Contributions

The project administrator is SB. Data were prepared by MR. The methodology was discussed with JP, MR, CC, CV and SB. JP carried out the analyses and wrote the main text of the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Juliette Piveteau.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. The results presented in this paper have not been published previously in whole or part, except in abstract format.

Ethical approval

The restrictions due to French Personal data protection regulation (CNIL) prohibit the authors from making the minimal data set publicly available. The French REIN registry received the authorization from the CNIL (Commission Nationale de l’Information et des Libertés) in 2010 (agreement number: 903188 Version 3). This procedure was approved by the ethics committee.

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This study does not involved directly patients.

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All involved subjects received an information leaflet before giving their verbal consent to participate.

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Piveteau, J., Raffray, M., Couchoud, C. et al. Pre-dialysis care trajectory and post-dialysis survival and transplantation access in patients with end-stage kidney disease. J Nephrol 36, 2057–2070 (2023). https://doi.org/10.1007/s40620-023-01711-y

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