The goal of this study is to evaluate quality of life (QoL) and frailty trajectories from advanced chronic kidney disease (CKD) to after dialysis initiation, specifically comparing patients choosing home dialysis and in-center hemodialysis.
The main questions it aims to answer are:
1. What is the trajectory of QoL in patients transitioning from advanced CKD to dialysis (up to 12 months after initiation) and how does these changes differ for patients oriented towards home dialysis and in-center hemodialysis? 2. Is the development of frailty after dialysis initiation less likely in patient pursuing home dialysis? 3. What is the variation in other PROMs and health outcomes (fatigue, anxiety \& depression, general assessment, cognitive function) form advanced CKD to the first 12 months after dialysis initiation? 4. What are the predictors of severe decline in QoL, frailty and other important health outcomes (fatigue, cognition, anxiety \& depression) during CKD G5 follow-up and after 12 months post dialysis initiation?
Participants will be ask to:
* Answer some questions and complete questionnaires each 3 months; * Do a a grip test and a walking test each 6 months to evaluate their frailty;
Adult patients followed in advanced CKD clinic;
eGFR ≤12 mL/min/1.73m2 96;
Understand English or French.
Orientation toward conservative treatment;
Planned kidney transplantation < 6 months;
Unable to provide consent due to severe cognitive or psychiatric disease;
Previous treatment with dialysis > 3 month;
Adults followed in advanced chronic kidney disease clinics recruited from 7 centers across Canada
Cohort
Prospective
Home dialysis or In-Center dialysis
Other interventionInitiation of dialysis with home dialysis (peritoneal dialysis or home hemodialysis) or in-center dialysis (hemodialysis)
Change in Kidney Disease Quality of Life - 36
Patients Scale from 0-100 (0 = poor, 100 = excellent).
Change in Fried Frailty phenotype
5 components (slowness, weakness, weight loss, low physical activity, exhaustion) with classification as no-frail, pre-frail or frail.
Change in Clinical Frailty Scale
Scale 1 (very fit) to 9 (terminally ill)
Change in Hospital Anxiety and Depression
14 items scale (7 anxiety, 7 depression) with score \>8 as cut-off for increased risk of depression and anxiety.
Change in Fatigue
3 items questionnaire to assess fatigue and energy.
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Ciusss de L'Est de l'Île de Montréal
Lead sponsor
The Kidney Foundation of Canada
Collaborator
