{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T22:55:59Z","timestamp":1770418559809,"version":"3.49.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic Kidney Disease (CKD) is a significant public health issue due to its increasing prevalence and associated high morbidity and mortality rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study evaluates the impact of multidisciplinary care pathways consisting of medical, dietetic and coordinating nurse follow ups, on kidney function, survival, clinical biological parameters and quality of life in patients with advanced CKD (stages 4 and 5). A retrospective analysis of clinical and biological parameters was conducted, alongside a prospective assessment of quality of life using the EQ-5D-5L tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 359 patients, (141 with\u00a0complete multidisciplinary\u00a0follow-up, 100 with\u00a0partial follow-up, and 118 with\u00a0medical-only\u00a0follow-up), mortality rates were significantly higher in the medical-only group (26%) compared to those who received\u00a0complete (8%) and partial multidisciplinary\u00a0follow-up (16%) (p\u2009&amp;lt;\u20090.001). No significant differences were observed in kidney function progression or dialysis initiation. Autonomy (Pearson's chi-square: 15.32, p\u2009=\u20090.05) and overall quality of life in the medical-only group were significantly lower (Cumulative Adjusted EQ-5D-5L- complete follow-up: 0.83, partial follow-up: 0.82 and medical only: 0.70-p\u2009=\u20090.037), as was the quality-of-life visual self-assessment (EQ VAS Scores\u2013 complete follow-up: 65, partial follow-up: 63 and medical only: 53 p\u2009=\u20090.024). The differences are important and clinically relevant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The current study suggests that participation in a Multidisciplinary Care Pathway does not significantly change kidney function progression or dialysis initiation but may be associated with decreased mortality and better quality of life parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-025-02365-8","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T18:35:08Z","timestamp":1761590108000},"page":"2775-2784","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of multidisciplinary care pathways on kidney function in patients with advanced chronic kidney disease: multicenter study"],"prefix":"10.1093","volume":"38","author":[{"given":"H\u00e9l\u00e8ne","family":"Pag\u00e8s","sequence":"first","affiliation":[{"name":"Aura Sante, IPA.Aura Sante 105 Avenue de La R\u00e9publique 63010 Clermont Ferrand France 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7973-6915","authenticated-orcid":false,"given":"Georges","family":"Kosmadakis","sequence":"additional","affiliation":[{"name":"Aura Sante, IPA.Aura Sante 105 Avenue de La R\u00e9publique 63010 Clermont Ferrand France 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatima El","family":"Kanouni","sequence":"additional","affiliation":[{"name":"Aura Sante, IPA.Aura Sante 105 Avenue de La R\u00e9publique 63010 Clermont Ferrand France 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aura","family":"N\u00e9coara","sequence":"additional","affiliation":[{"name":"Aura Sante, IPA.Aura Sante 105 Avenue de La R\u00e9publique 63010 Clermont Ferrand France 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Baudenon","sequence":"additional","affiliation":[{"name":"Aura Sante, IPA.Aura Sante 105 Avenue de La R\u00e9publique 63010 Clermont Ferrand France 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cl\u00e9mence","family":"Deville","sequence":"additional","affiliation":[{"name":"Aura Sante, IPA.Aura Sante 105 Avenue de La R\u00e9publique 63010 Clermont Ferrand France 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana","family":"Enache","sequence":"additional","affiliation":[{"name":"Aura Sante, IPA.Aura Sante 105 Avenue de La R\u00e9publique 63010 Clermont Ferrand France 1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Audrey","family":"Murat-Ringot","sequence":"additional","affiliation":[{"name":"https:\/\/ror.org\/01502ca60 grid.413852.9 0000 0001 2163 3825 Hospices Civils de Lyon Lyon France 2"},{"name":"UR 4129 Parcours Sant\u00e9 Syst\u00e9mique (P2S) Lyon1 France 3"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"Verot","sequence":"additional","affiliation":[{"name":"UR 4129 Parcours Sant\u00e9 Syst\u00e9mique (P2S) Lyon1 France 3"},{"name":"https:\/\/ror.org\/04pn6vp43 grid.412954.f 0000 0004 1765 1491 CIC 1408 Inserm, CHU de Saint-Etienne Saint-Priest-en-Jarez France 4"},{"name":"https:\/\/ror.org\/04yznqr36 grid.6279.a 0000 0001 2158 1682 Institut Universitaire de Recherche PRESAGE, Chaire Hyg\u00e9e, Universit\u00e9 Jean Monnet Saint-Etienne France 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January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All the authors declare no competing interests in regard to the present study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}},{"value":"The study was approved by the ethics committee of Saint-Etienne on December 8, 2023, under the reference IRBN1502023\/CHUSTE, and complied with CNIL's MR004 methodology, registered under no. 2231741v0. Use of the EQ-5D-5L required prior authorization from Euroquol, with registration number 59836 obtained for non-commercial use. The study was registered on ClinicalTrials.gov under the number NCT06219798, ensuring transparency and adherence to international standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The present study complies with the guidelines for human studies.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}