Prognostic Determinants of Survival and Quality of Life in Prevalent End-stage Kidney Disease Patients
Prognostic Determinants of Survival and Quality of Life in Prevalent End-stage Kidney Disease Patients
Patients with end-stage kidney disease are treated with dialysis to increase their life
 expectancy as well as their quality of life (QoL). Scientific researchers are currently still
 looking for markers to evaluate dialysis in an objective way. It has been proven before that
 the currently clinically used parameters (like the dialysis adequacy parameter Kt/V) are not
 appropriate enough to estimate dialysis dose.

 The current project aims at identifying potential (predicting) biomarkers based on functional
 capacity, nutritional status and/or QoL.
This multisite study is an observational study during which prevalent dialysis patients are
 followed during maximum 3 years, and they undergo different tests.

 Once a year (max 3 times), blood is sampled, stool is collected, and finger nails are taken
 all before a midweek session. Demographic data are registered and Davies-Stokes scores are
 calculated. Blood is analysed for different solutes: e.g. total and free fractions of
 protein-bound toxins, sedimentation, erythrocytes, hematocrit, leukocytes, thrombocytes,
 Ferritin, VitB12, Fasting glucose, c-reactive protein, urea, creatinine, albumin, total
 protein, cholesterol, triglycerides, bilirubin,...

 At the same occasion, patients are questioned about different items (QoL, nutrition) by a
 (study) nurse or coordinator, using different questionnaires: Euroqol 5 dimension scale
 (EQ-5D), Patient-Reported Outcomes Measurement Information System (Promis-29), and Mini
 Nutritional Assessment (MNA).

 A subgroup of patients were asked to perform some functional tests: Tinetti-Test, Sit to
 Stand (5 times), Frailty and Injuries: Cooperative Studies on Intervention Techniques
 (Ficsit) test, 2 or 6 minutes walking test, handgrip strength and quadriceps power
 measurement, back scratch test, compensatory stepping correction-backward test and skin fold
 measurement. All tests are non-invasive and are validated for routine measurements in the
 elderly.

 In order to quantify sleep, patients were asked to wear a Motionwatch (Actigraphy) to
 register their arm movements during 2 or 3 nights as well as to fill out 2 questionnaires
 related to sleep: Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). To
 compare sleep in dialysis patients with healthy persons, age and gender matched healthy
 volunteers were also included in the study and were asked to sleep 2 or 3 nights with the
 Motionwatch and to complete the ISI and PSQI.

 Patients who were transplanted got an extra blood sampling just before transplantation as
 well as 4 months after transplantation.
Inclusion Criteria:

 - end-stage kidney disease patients treated with dialysis (peritoneal dialysis or
 hemodialysis)

 Exclusion Criteria:

 -  active inflammation

 -  malignancy

 -  cognitive disorder

 -  not understanding the dutch language