Impact of the Implementation of CKD Coordination Function on Dialysis Initiation Frequency in Emergency

Study Overview
=================
Brief Summary
-----------------
Kidney failure is a major public health problem. REIN registry shows that 33% of patients treated in renal replacement therapy for ESRD start dialysis in emergency. Unscheduled care is associated with an increased risk of morbidity and mortality, with less access to off dialysis center and kidney transplant. In addition, the emergency management has an impact on the organization of health structures. The High Authority of Health in 2012 issued a care pathway Guide aimed to report in this process of the multidisciplinary nature of the management and coordination of principles and procedures for the Chronic Renal failure and cooperation between professionals involved.  A function of coordinator of the Chronic Renal Disease was set up in service since May 2013. Investigators propose to carry out a study to value its impact on the start of the dialysis in emergency and hypothesize that this feature innovative in France improves the patient pathway and thus reduce support emergency frequency of ESRD. The objective of this study is to show the improvement of the quality of care for terminally chronic renal failure patients. This is to evaluate an experiment aimed to facilitate a complex care path. If this experiment is successful, it could form part of advanced practice.

Official Title
-----------------
Impact of the Implementation of a Chronic Kidney Disease (CKD) Coordination Function on Dialysis Initiation Frequency in Emergency

Conditions
-----------------
Chronic Kidney Disease

Intervention / Treatment
-----------------
* Other: Post implementation


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients over 18 years with terminal chronic renal failure enrolled in the course of care Exclusion Criteria: Patients under 18 years Patient Off Course Patient beginning dialysis with a method of transition

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Before implementation<br>Patients registered in monitoring French registry of renal patients Réseau Epidémiologie et Information en Néphrologie (REIN) from January 1, 2012 to December 31, 2013 | |
| Post implementation<br>Patients registered in monitoring French registry of renal patients Réseau Epidémiologie et Information en Néphrologie (REIN) from January 1, 2014 to December 31, 2015 | Other: Post implementation<br>* Patient group whose care course was organized by the nurse coordinator of chronic renal failure<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of emergency dialysis patients beginner | The outcome is mesured at baseline (implementation of the nurse coordinator of chronic renal failure the nurse coordinator of chronic renal failure Baseline = implementation of this function of coordination of patients with chronic renal failure | Change of this percentage from baseline at 2 years | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
emergency, coordination, dialysis