Perceptions About the Dialysis Modality Decision Process Among Peritoneal Dialysis and In-center Hemodialysis Patients

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2018 Oct 31

PMID 30373558

Citations 10

Authors

Jarcy Zee

Junhui Zhao

Lalita Subramanian

Erica Perry

Nicole Bryant

Margie McCall

Yanko Restovic

Delma Torres

Bruce M Robinson

Ronald L Pisoni

Francesca Tentori

Affiliations

Soon will be listed here.

Abstract

Background: Patients reaching end-stage renal disease must make a difficult decision regarding renal replacement therapy (RRT) options. Because the choice between dialysis modalities should include patient preferences, it is critical that patients are engaged in the dialysis modality decision. As part of the Empowering Patients on Choices for RRT (EPOCH-RRT) study, we assessed dialysis patients' perceptions of their dialysis modality decision-making process and the impact of their chosen modality on their lives.

Methods: A 39-question survey was developed in collaboration with a multi-stakeholder advisory panel to assess perceptions of patients on either peritoneal dialysis (PD) or in-center hemodialysis (HD). The survey was disseminated to participants in the large US cohorts of the Dialysis Outcomes and Practice Patterns Study (DOPPS) and the Peritoneal DOPPS (PDOPPS). Survey responses were compared between PD and in-center HD patients using descriptive statistics, adjusted logistic generalized estimating equation models, and linear mixed regression models.

Results: Six hundred fourteen PD and 1346 in-center HD participants responded. Compared with in-center HD participants, PD participants more frequently reported that they were engaged in the decision-making process, were provided enough information, understood differences between dialysis modalities, and felt satisfied with their modality choice. PD participants also reported more frequently than in-center HD participants that partners or spouses (79% vs. 70%), physician assistants (80% vs. 66%), and nursing staff (78% vs. 60%) had at least some involvement in the dialysis modality decision. Over 35% of PD and in-center HD participants did not know another dialysis patient at the time of their modality decision and over 60% did not know the disadvantages of their modality type. Participants using either dialysis modality perceived a moderate to high impact of dialysis on their lives.

Conclusions: PD participants were more engaged in the modality decision process compared to in-center HD participants. For both modalities, there is room for improvement in patient education and other support for patients choosing a dialysis modality.

Citing Articles

Physician Knowledge and Attitudes Toward the Adoption of Peritoneal Dialysis in the Treatment of Patients With End-Stage Kidney Disease.

Lalani H, Ganguly A, Brown L, Smartt J, Johnson D, Bhavan K Cureus. 2023; 14(12):e32708.

PMID: 36686081 PMC: 9848698. DOI: 10.7759/cureus.32708.

Peritoneal dialysis after shared decision-making: the disparity between reality and patient expectations.

Ho Y, Hsu P, Yang K BMC Nurs. 2022; 21(1):268.

PMID: 36180845 PMC: 9524315. DOI: 10.1186/s12912-022-01043-5.

Late Dialysis Modality Education Could Negatively Predict Peritoneal Dialysis Selection.

Nakayama T, Nishioka K, Uchiyama K, Morimoto K, Kusahana E, Washida N J Clin Med. 2022; 11(14).

PMID: 35887805 PMC: 9315828. DOI: 10.3390/jcm11144042.

An Arterial Anastomosis Stenosis Used in Lieu of Banding to Prevent Dialysis Access Steal Syndrome.

Young J, Reyes C, Erinle A Cureus. 2022; 14(5):e24757.

PMID: 35676983 PMC: 9167043. DOI: 10.7759/cureus.24757.

The role of personal attitudes of control and responsibility for the uptake of peritoneal dialysis- a national survey among dialysis patients.

Schellartz I, Ohnhaeuser T, Mettang T, Scholten N BMC Nephrol. 2021; 22(1):107.

PMID: 33761891 PMC: 7989083. DOI: 10.1186/s12882-021-02303-3.

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