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About the polder initiative

The POLDER initiative develops a care pathway for older patients with End Stage Renal Disease (ESRD). By assessing a geriatric assessment, patients and health care providers take into account all aging aspects in the treatment plan.  How frail is a person, and how does he function physically and cognitively?  

Understanding the effects of  chronic kidney failure on aging. And improving healthcare accordingly. 


Our aim


To prepare implementation of a national registry for chronic care in older patients with ESRD, to study determinants of adverse outcomes, implement interventions and improve outcomes for these patients.

We believe that the implementation of a geriatric assessment and a national registry in pre-dialysis care for older patients with ESRD will:

1) provide insights in determinants of adverse outcomes.
2) inform and benefit decision making trajectories for treatment modality, and
3) will improve outcomes for these patients. 



nationwide cooperation

POLDER is an acronym for Pathway for Older Patients Reaching End Stage Renal Disease

Multiple Dutch hospitals and academic centers cooperate to develop and improve healthcare for the older renal patient.

In a pilot project we study the feasibility of implementation of a geriatric assessment in routine pre-dialysis care. The POLDER study involves capturing the clinical and geriatric data in a national database and collecting biomaterial for future research.


Participating hospitals

.Amsterdam University Medical Center (AMC ánd VUMC)
.Haga Hospital 
.Haaglanden Medical Center+ 
.Leiden University Medical Center
.Maasstad Hospital
.Maasstricht University Medical Center 
.Radboud University Medical Center
.Reinier de Graaf Hospital
.University Medical Center Groningen
.University Medical Center Utrecht
.St. Antonius Hospital

Hospitals related to the initiative:
.Diakonnessenhuis Utrecht
.Elkerliek Hospital
.Gelre Hospital
.Jeroen Bosch Hospital
.Medical Center Leeuwarden 



Improving healthcare for older renal patients

polder in a nutshell

  • The POLDER intiative is a cooperation between multiple peripheral and academic hospitals. By implementing the same care pathway - a geriatric assessment in pre dialysis care- we can learn from each other. 
  • Sharing knowledge and outcomes to improve healthcare is an important aspect of this care pathway. Both patients and health care providers (such as the nephrologist, geriatrician, renal nurse, dietician, and the social worker) should discuss the  outcomes and implications of the geriatric assessment.
  • If necessary, additional care can be provided, like dietary prescriptions, physiotherapy or other care. 
  • The POLDER project provides additional education for health care providers working in renal care. 
  • Clinical and geriatric data will be gathered in a nationwide database in order to investigate the effects of kidney failure on the aging process. 

results of the POLDER study

First results are expected in 2019