This multicentre, randomised open-label, blinded endpoint-assessment trial randomised participants receiving maintenance haemodialysis therapy to either extended (≥24hrs) or standard (12-18hrs) weekly haemodialysis for 12 months. A web-based randomisation system used minimisation to ensure balanced allocation across regions, dialysis setting and dialysis vintage. The primary outcome is the change in quality of life over 12
months of study treatment assessed by EQ5D. Secondary outcomes include change in left ventricular mass index assessed by magnetic resonance imaging and safety find more outcomes including dialysis access events. A total of 200 participants were recruited between 2009 and 2013 from Australia (29.0%), China (62.0%), Canada (5.5%) and
New Zealand (3.5%). Participants had a mean age of 52 (±12) years and 11.5% were dialysing at home, with a mean duration of 13.9 hours per week over a median of 3 sessions. At baseline, 32.5% had a history of cardiovascular disease and 36.5% had diabetes. The ACTIVE Dialysis Study has met its planned recruitment target. The participant population are drawn from a range of health service settings in a global context. The study will contribute important evidence on the benefits and harms of extending weekly dialysis hours. The trial is registered at clinicaltrials.gov (NCT00649298). “
“Aim: Multidisciplinary care of patients with chronic kidney disease (CKD) provides better care outcomes. This study is to evaluate the effectiveness of a CKD Epigenetics Compound Library care program on pre-end-stage renal disease (ESRD) care. Methods: One hundred and forty incident haemodialysis patients were classified into the CKD Care Group (n = 71) and the Nephrologist Care Group (n = 69) according to participation in the CKD care program before dialysis initiation. The ‘total observation period’ was oxyclozanide divided into ‘6 months before dialysis’ and ‘at dialysis initiation’. Quality of pre-ESRD care, service utilization and medical costs were evaluated and compared between groups. Results: The mean estimated glomerular filtration rates at dialysis
initiation were low in both groups; but the levels of haematocrit and serum albumin of the CKD Care Group were significantly higher. The percentages of patients initiating dialysis with created vascular access, without insertion of double-lumen catheter and without hospitalization were 57.7%, 50.7% and 40.8%, respectively, in the CKD Care Group, and 37.7%, 29.0% and 18.8% in the Nephrologist Care Group (P < 0.001). Participation in the CKD care program, though with higher costs during the 6 months before dialysis ($US1428 ± 2049 vs US$675 ± 962/patient, P < 0.001), was significantly associated with lower medical costs at dialysis initiation ($US942 ± 1941 vs $US2410 ± 2481/patient, P < 0.001) and for the total period of observation ($US2674 ± 2780 vs $US3872 ± 3270/patient, P = 0.009).