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Behaviour and Cognitive Evaluation for Dialysis Elderly Patients (BCDE) (BCDE)

This study has been terminated.
Sponsor:
Information provided by (Responsible Party):
Centre Hospitalier Universitaire de Nice
ClinicalTrials.gov Identifier:
NCT01225458
First received: October 20, 2010
Last updated: September 14, 2016
Last verified: September 2016
  Purpose

The trial is a multicenter, prospective, randomized, open study. A total of 500 elderly patients aged over 75 years with renal insufficiency stage 5 will be included in the study after signed informed consent. Patients will be randomized 1/1 in two arms : 250 patients in the "exclusive nephrology follow-up" arm will continue their usual follow-up; 250 patients in the "geriatric follow-up" arm will have both their usual nephrology follow-up and a geriatric follow-up.

The aim of the study is to determine if a systematized gerontologist evaluation delay the occurrence of a composite primary endpoint : death, dementia, depression and severe dependency. The hypothesis is that the functional and vital prognosis of a patient with renal insufficiency depends not only on common and classical factors but also on cognitive and psychological functions and dependence, particularly in elderly patients.


Condition Intervention
Chronic Renal Insufficiency Chronic Kidney Failure Aged Other: shorter tests Other: initial complete geriatric tests Other: follow-up complete geriatric tests

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Behaviour and Cognitive Evaluation for Dialysis Elderly Patients (BCDE)

Further study details as provided by Centre Hospitalier Universitaire de Nice:

Primary Outcome Measures:
  • death [ Time Frame: every 6 month for 3 years since inclusion ]
  • occurrence of a severe dementia (MMS < 10) [ Time Frame: every 6 month for 3 years since inclusion ]
  • major depression detected by GDS-15 > 10/15 and confirmed by DSM-IV criteria [ Time Frame: every 6 month for 3 years since inclusion ]
  • severe dependency (ADL < 3/6) [ Time Frame: every 6 month for 3 years since inclusion ]

Secondary Outcome Measures:
  • cognitive, psychic and autonomy scores [ Time Frame: every 6 month for 3 years since inclusion ]
  • cardiovascular morbidity and mortality [ Time Frame: every 6 month for 3 years since inclusion ]
  • bone fracture [ Time Frame: every 6 month for 3 years since inclusion ]
  • nutritional parameters [ Time Frame: every 6 month for 3 years since inclusion ]
  • dialysis parameters [ Time Frame: every 6 month for 3 years since inclusion ]
  • biological follow-up of chronic kidney disease including haemoglobin level [ Time Frame: every 6 month for 3 years since inclusion ]

Enrollment: 48
Study Start Date: July 2008
Study Completion Date: January 2015
Primary Completion Date: January 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: exclusive nephrology follow-up
250 patients will be included and randomized in the "exclusive nephrology follow-up" arm will continue their usual nephrology follow-up with consultations every 6 months during 3 years for dialysis patients or with consultations every 6 months before dialysis, 3 months after starting dialysis and every 6 months for a total duration of 3 years for non-dialysis patients. In addition to their nephrology consultations, patients will benefit from a geriatric evaluation with MMS, GDS and ADL scoring.
Other: shorter tests
Geriatric evaluation with MMS, GDS and ADL scoring
Other: initial complete geriatric tests
evaluation of cognitive functions, psychological functions, dependency in activities, vision, audition, mobility and nutritional status : only at the first visit
Experimental: geriatric follow-up

250 patients will be included and randomized in the "geriatric follow-up" arm. They will continue their usual nephrology follow-up with consultations every 6 months during 3 years for dialysis patients or with consultations every 6 months before dialysis, 3 months after starting dialysis and every 6 months for a total duration of 3 years for non-dialysis patients.

About geriatric evaluation Patients randomized in this arm will also have more complete tests to evaluate cognitive functions (memory, language and movements), psychological functions (depression and anxiety) and dependency in activities of daily living. Other tests will allow evaluate vision, audition, mobility and nutritional status.

Other: shorter tests
Geriatric evaluation with MMS, GDS and ADL scoring
Other: initial complete geriatric tests
evaluation of cognitive functions, psychological functions, dependency in activities, vision, audition, mobility and nutritional status : only at the first visit
Other: follow-up complete geriatric tests
evaluation of cognitive functions, psychological functions, dependency in activities, vision, audition, mobility and nutritional status : every 6 month for 3 years

  Eligibility

Ages Eligible for Study:   75 Years and older   (Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion criteria :

  • Patients aged of 75 years old or more,
  • Chronic kidney disease stage 5 defined by :
  • either an estimated GFR (MDRD) ≤ 15ml/mn/1,73 m² in a non-dialysis patient with a nephrology follow-up > 3 months ("Pre-dialysis cohort"),
  • or a dialysis treatment started for more than 3 months and less than one year, after a pre-dialysis follow-up > 3 months ("post-dialysis cohort"),
  • Signed and dated informed consent.

Exclusion criteria :

  • Moderately severe to severe dementia (MMS ≤ 15),
  • Major depression and/or GDS-15 > 10/15,
  • Severe dependency (ADL < 3/6).,
  • Psychosis, mutism or aphasia,
  • Malignancy or any pathology with life expectancy < one year.
  • Ongoing specialized geriatric care
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01225458

Locations
France
CHU de Nice
Nice, France, 06000
Sponsors and Collaborators
Centre Hospitalier Universitaire de Nice
  More Information

Responsible Party: Centre Hospitalier Universitaire de Nice
ClinicalTrials.gov Identifier: NCT01225458     History of Changes
Other Study ID Numbers: BCDE
Study First Received: October 20, 2010
Last Updated: September 14, 2016

Keywords provided by Centre Hospitalier Universitaire de Nice:
Elderly patients
renal insufficiency
systematized gerontologic evaluation

Additional relevant MeSH terms:
Renal Insufficiency
Renal Insufficiency, Chronic
Kidney Failure, Chronic
Kidney Diseases
Urologic Diseases

ClinicalTrials.gov processed this record on July 25, 2017