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Update RICH-Q. Advisory Board Meeting October 2011. RICH-Q 1 → RICH-Q 2. -Goals and achievements -Publications -Current number of patients. Goals RICH-Q 1. To establish the current quality of care in children with ESRD in the Netherlands and Belgium

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update rich q

Update RICH-Q

Advisory Board Meeting

October 2011

rich q 1 rich q 2
RICH-Q 1 → RICH-Q 2

-Goals and achievements

-Publications

-Current number of patients

goals rich q 1
Goals RICH-Q 1
  • To establish the current quality of care in children with ESRD in the Netherlands and Belgium
  • To increase the quality of care of children with ESRD by frequent peer review and discussions of local outcomes
  • To build up a comprehensive database on treatment characteristics and outcomes in order to conduct prospective outcomes studies
  • To foster clinical studies
achieved
Achieved
  • Database and website
  • Survey of treatment policies
  • Advisory board meetings (8)
  • 11 centers: Cologne
  • Consensus meetings of quality indicators/ benchmarks
  • 2SR’s

management of children with ESRD

PWV measurement instruments.

  • Assessment of the reproducibility and validity of PWV and echocardiogram measurements
  • Add-on studies
  • Study groups
  • Several presentations
  • Papers
what have we learned 1
What have we learned? (1)
  • Important differences in dialysis policies:

- between centres

- between policy and actual care

  • 17 guidelines, 369 recommendations

only 6% evidence based

  • Immigrants

- Tx: less pre-emptive and living donor

higher risk for acute rejection

- Dialysis: more HD (less PD)

longer HD, more ROD, more peritonitis

slide6

What have we learned? (2)

  • Pulse Wave Velocity
    • Smallest Detectable Change 1.05 m/s
  • Echocardiogram
    • low agreement diagnosis LVH
    • Smallest Detectable Change 1.6 mm
  • Tissue doppler: more detection of DD compared to conventional echocardiogram
not yet achieved
Not yet achieved
  • Change in QoC
    • (guideline implementation and benchmarks)
  • Useful outcome measures
  • Continuation of the add-on studies
accepted
Accepted
  • Comparison of two instruments measuring carotid-femoral pulse wave velocity: Vicorder versus SphygmoCor JoH
  • Lessons learned from efforts to improve the quality of care in children with end-stage renal disease in the Netherlands and Belgium. ADC
  • Important differences in management policies for children with end-stage renal disease in the Netherlands and Belgium – Report from the RICH-Q study. NDT
  • Less pre-emptive renal transplantations and more rejections in immigrant children compared to native Dutch and Belgian children. NDT
submitted
Submitted
  • Scope and foundation of current guidelines for the management of chronic dialysis in children; a systematic review: a systematic review. NDT
  • Reproducibility of pulse wave velocity measurement in children with end-stage renal disease. Ped Neph
  • Chronic dialysis treatment and outcomes differ between immigrant and native Dutch and Belgian children. Ped Neph
  • Clinimetric characteristics of instruments that measure pulse wave velocity in adults and children are poorly reported: a systematic review. J. Clin epi.
in progress
In progress
  • Low agreement between cardiologists diagnosing LVH in children with ESRD
  • Does Tissue Doppler measurement lead to earlier detection of diastolic dysfunction in children with ESRD than conventional ultrasound measurement of E/A ratio?
  • Important differences in management policies for renal transplantation in children in the Netherlands and Belgium -Report from the RICH-Q study
  • The RICH-Q effect of 4 years feedback of care information, peer discussion and guideline development on standard of care in centres for RRT in children
  • Quality of life in Dutch and Belgian children with End Stage Renal Disease
therapy at start richq

Total: 260

HD: 91

PD: 114

TX: 55

Therapy at start RICHQ

Total: 230

HD: 77PD: 105

TX: 48

current therapy

Total: 215

HD: 32

PD: 40

TX: 143

Current therapy
outflow n 45
Outflow (n=45)
  • Deceased: 6
  • - Primary disease (2): Complications of cong. heart disease operation, - Wilmstumor with metastasis,

- Secondary disease (4):

Pulmonary hypertension, - Postoperative complication after changing a hemodialysis catheter (no autopsy),

-2x Respiratory insufficiency (1x no informed consent)

  • Adult care: 34
  • No informed consent: 3
  • Pre emptive Tx failure without cRRT: 1
  • Moved: 1
patients missing
Patients missing?

Year of inclusion

Centre

data entry delay
Data entry delay

Measurements points: 141 missing

  • HD: 36
  • PD: 58
  • Tx (without M0 and M3) : 47
slide18
NfN indicators

(dialysis)

thesis of marieke tromp
Thesis of Marieke Tromp
  • Manuscript? Adres

Friday 25 nov. 2011

  • Thesis defence and reception:

12.00, Amsterdam.

  • Party 21.00, Amsterdam
thank you gift
Thank you gift

RICH-Q Book.

  • pictures/ stories/ drawings from children/ personal note/ etc…
  • Please email me your personal message to Marieke before November 1th.
ad