The comprehensive dialysis study (CDS): a USRDS special study.
OBJECTIVE
The Comprehensive Dialysis Study (CDS) aimed to understand factors contributing to physical, functional, and nutritional health status among patients starting dialysis.


METHODS
A phone interview survey was conducted with patients from a geographically stratified national random sample of dialysis units, and quarterly serum samples were obtained for patients at a preidentified subset of units. The phone survey collected standardized measures of physical activity, employment and disability status, perceived health and well-being, and dietary intake. Serum samples were obtained to measure prealbumin, albumin, creatinine, normalized protein catabolic rate, and C-reactive protein. To comply with restrictions required under the Health Insurance Portability and Accountability Act (HIPAA), dialysis unit personnel could not participate in any research-related activities.


RESULTS
Overall participation rate was 18.5%. One thousand six hundred forty-six patients affiliated with 295 dialysis units completed the phone survey; 361 patients affiliated with 68 dialysis units also completed a dietary intake survey, with 269 providing serum samples. Despite challenges in the design and implementation of CDS, the population was diverse and results should be generalizable.


CONCLUSIONS
Constraints within the dialysis industry and HIPAA requirements render the assembly of nationally representative cohorts extremely difficult. Nevertheless, the CDS represents the largest cohort of incident dialysis patients containing detailed information on self-reported physical activity and dietary intake and is one of few cohorts simultaneously measuring laboratory proxies of nutrition and inflammatory status. Data from CDS can be used to inform the design of interventions addressing several conditions that affect longevity and health status in ESRD.
Kutner
Nancy G
NG
Rehabilitation/Quality of Life Special Studies Center, United States Renal DataSystem, Emory University, Atlanta, Georgia, USA.
Johansen
Kirsten L
KL
Kaysen
George A
GA
Pederson
Sarah
S
Chen
Shu-Cheng
SC
Agodoa
Lawrence Y
LY
Eggers
Paul W
PW
Chertow
Glenn M
GM
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003404:Creatinine / Q000097:blood; D019992:Databases as Topic; D003956:Dialysis / Q000706:statistics & numerical data*; D004032:Diet; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011228:Prealbumin / Q000032:analysis; D011446:Prospective Studies; D011788:Quality of Life; D012709:Serum Albumin / Q000032:analysis; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D015415:Biomarkers; D011228:Prealbumin; D012709:Serum Albumin; D002097:C-Reactive Protein; D003404:Creatinine