European QUALity Study on treatment in advanced chronic kidney disease


Cynthia Janmaat, PhD student

Project managers

Dr M. van Diepen, Prof.dr F.W. Dekker


Centers in Germany, Italia, Poland, Sweden, The Netherlands, and UK



In patients of 65 years and older with end-stage renal disease (ESRD), dialysis is usually started at a renal function, as indicated with estimated glomerular filtration rate (eGFR) of 5 to 15 ml/min/1.73m2. Over the past decade, there has been a trend to start dialysis at higher levels of eGFR to make a so-called ‘healthy start’. From the patients perspective, it is suggested that in some countries a substantial number of elderly patients wish to postpone dialysis (or prefer not to start dialysis at all). With adequate prescription of relevant medication and diet dialysis might indeed be safely postponed or even not started in elderly ESRD patients as for specific patient groups the burden of dialysis may be bigger than the benefit.

We aim to find the best timing of starting dialysis when considering patient survival and quality of life. To that end, patients with a low renal function not yet on dialysis will be included in a prospective follow-up study. Six European countries participate in this study which is supported by the ERA-EDTA and the Dutch Kidney Foundation. So far, > 1500 patients have been included.