[The pharmaco-epidemiology to evaluate clinical practices and their impact on health, regarding an example in nephrology: the AVENIR study]

Abstract

The AVENIR study is a pharmaco-epidemiological study, lead in Lorraine region (France) between 1st January, 2005 and 31st December, 2006, which aim at: evaluating the quality of therapeutic practices, delivered by nephrologists, for chronic kidney disease patients during the year preceding dialysis onset, assessing the association between quality of predialysis therapeutic practices and survival and hospitalization during the first year of dialysis, and health-related quality of life at dialysis onset. Several data were collected for the AVENIR study: demographic, clinical, biological and therapeutic data before dialysis, morbidity and mortality during dialysis treatment. These data were used for secondary analyses investigating the decline in glomerular filtration rate over the year preceding dialysis, the management of hypertension and proteinuria before dialysis, and characteristics and outcomes of patients with delayed dialysis initiation. Results from the AVENIR study have been published in various international journals. The aim of this manuscript is to present a summary of these results and the lessons we can learn for the nephrological practice.