Original InvestigationsEvaluation of DOQI guidelines: Early start of dialysis treatment is not associated with better health-related quality of life*,**,*,**
Section snippets
Patients
All new patients with end-stage renal disease (ESRD) from 29 Dutch dialysis centers were consecutively invited to participate in the study. These patients participated in The Netherlands Cooperative Study on the Adequacy of Dialysis-2 (NECOSAD-2), a large multicenter prospective study. The aim of this study was to monitor the quality and adequacy of dialysis treatment in The Netherlands. Eligibility criteria for the cohort were: 18 years or older, availability of residual renal function data 0
Results
Three hundred eighteen patients satisfied the criteria for inclusion. We excluded 14 patients because of inaccurate urine collection, 20 patients because they had malignancy, and another 31 patients because they did not receive predialysis care. In addition, 13 patients did not want to participate in the HRQOL assessment. Three patients did not complete an HRQOL questionnaire at any scheduled measurement.
Two hundred thirty-seven patients were available for analysis, of which 90 patients (38%)
Discussion
This prospective multicenter study of dialysis patients showed that patients starting late with chronic dialysis treatment had lower perceived HRQOL for a number of dimensions at dialysis therapy initiation. For the majority of dimensions, a substantial improvement in HRQOL was observed in all groups of patients during the first 6 months of chronic dialysis treatment. Any differences that existed at the start of dialysis treatment were caught up within 12 months. As a result, after 1 year of
Acknowledgements
The authors thank the nursing staff of the dialysis centers, who collected most of the data, and A. Feller, A. Houweling, C. Janssen, B. Nijman, L. Ten Brinke, K. Voss, and R. Wisse, for their assistance in the logistics of this study.
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For the Netherlands Cooperative Study on the Adequacy of Dialysis study group: Apperloo AJ, Barendregt JNM, Birnie RJ, Boekhout M, Boer WH, van Bommel EFH, Büller HR, de Charro Fth, Doorenbos CJ, van Dorp WT, van Es A, Fagel WJ, Feith GW, Franssen CFM, Frenken LAM, van Geelen JACA, Geerlings W, Gerlag PGG, Gorgels JPMC, Grave W, Huisman RM, Jager KJ, Jie K, Koning-Mulder WAH, Koolen MI, Kremer Hovinga TK, Lavrijssen ATJ, van Manen JG, Mulder AW, Parlevliet KJ, Rosman JB, van Saase JLCM, Schonk MJM, Schuurmans MMJ, Stevens P, Tijssen JGP, Valentijn RM, Vastenburg G, Verburg CA, Verhagen CE, Verstappen VMC, Vincent HH, Vos P.
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Supported in part by grant no. E.018 from The Dutch Kidney Foundation and grant no. OG97/005 from the Dutch National Health Insurance Board.
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Address reprint requests to Johanna C. Korevaar, MSc, Department of Clinical Epidemiology and Biostatistics, J2-211, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands. E-mail: [email protected]
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