No registrations found.
ID
Source
Brief title
Health condition
1. Chronic kidney disease;
2. Diabetes mellitus;
3. Hypertension;
(NLD: verminderde nierfunctie, diabetes mellitus, hypertensie).
Sponsors and support
Radboud University Medical Center Nijmegen (UMCN)
Department of Nephrology, Radboud University Medical Center Nijmegen
Intervention
Outcome measures
Primary outcome
A blood pressure below 130/80 mmHg or decline in blood pressure of 5 mm Hg.
Secondary outcome
Patients with hypertension: BMI, stop smoking, course of eGFR, lipids, proteinuria, SCORE riskscore
Patients with diabetes mellitus: BMI, stop smoking, course of eGFR, proteinuria, glyHb, fasting bloodglucose, lipids, UKPDS riskscore.
Background summary
A randomized controlled trial will be performed: 9 GP practices will be randomised to control or intervention. Patients with hypertension and/or diabetes mellitus with an estimated glomerular filtration rate < 60 ml/min/1.73 m² (MDRD)will be included in the study with a minimum of 20 and a maximum of 28 patients per practice.
The patients in intervention practices will be monitored:
1. Cardiovascular risk (smoking, blood pressure, cardiovascular co-morbidity);
2. Laboratory: creatinine, ureum, sodium, potassium, calcium, phosphate, Hb, MCV, lipids, fasting glucose, glyHb;
3. Urine: albumin, protein, creatinine;
4. Important co morbidity;
5. Medication;
6. UKPDS or SCORE riskengine score.
After 12 months this monitoring will be repeated.
The intervention patients will be treated by GP and practice nurse according to a shared care model. Patients with a GFR < 30 ml/min/1.73 m² or a GFR between 30 ¨C60 GFR /min/1.73 m² and proteinuria will be presented to a nephrologist by web based consultation.
In control practices of the NMP project patients will receive usual care (according to the diabetes- and cardiovascular risk-guidelines of the Dutch College of General Practitioners).
Study objective
The hypothesis is that patients with chronic kidney disease will meet treating goals better when they are treated in a shared care model by a general practitioner, a practice nurse and with online consultation of a nephrologist.
Study design
Blood sample and blood pressure when included (baseline) and after 12 months.
Intervention
In intervention practices patients will be treated conform a shared care model by a practice nurse, a GP and a nephrologist. A treatment protocol and web based consultation will be part of this shared care model.
Goals are optimal management of cardiovascular risk.
VOHA 166,Postbus 9101
N.D. Scherpbier-de Haan,
Nijmegen 6500 HB
The Netherlands
024-3615300
n.scherpbier@voha.umcn.nl
VOHA 166,Postbus 9101
N.D. Scherpbier-de Haan,
Nijmegen 6500 HB
The Netherlands
024-3615300
n.scherpbier@voha.umcn.nl
Inclusion criteria
Patients with hypertension and/or diabetes mellitus with an estimated glomerular filtration rate < 60 ml/min/1.73 m² (MDRD).
Exclusion criteria
1. Patients with serious medical or psychiatric conditions or drug or alcohol abuse;
2. patients under specialist care for chronic kidney disease in the last year;
3. analphabetism or not being able to read/understand Dutch language (including cognitive disorders);
4. participation in another intervention trial within 30 days before the start of the study.
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL1105 |
| NTR-old | NTR1140 |
| Other | Department of General Practice, Nijmegen : PV 35 (dutch kidney foundation) |
| ISRCTN | ISRCTN wordt niet meer aangevraagd |