Introdution Pre dialysis education program (PDE) helps patients to decide which renal replacement therapy (RRT) to choose. Methods We evaluated the impact of personal, demographic parameters and pre-dialysis education program on patient choice of different treatment modalities such as haemodialysis (HD), peritoneal dialysis (PD) and conservative treatment (CT). We also compared HD and PD incidence before and after the implementation of our PDE. Results During a 9-year period, a total of 813 chronic kidney disease patients took part in the education program. Fifty nine per cent (n=482) chose hemodialysis (HD), 19 % (n=155) peritoneal dialysis (PD) and 12 % (n=100) conservative treatment (CT). The remaining 76 (9.4%) patients were submitted to conservative management due to their poor clinical status. CT was mainly selected by older and more disabled patients than those on PD and HD. Their mean age was 86.5±6.4, 72.6±13.3 and 60.8±16.0, respectively (p<0.001). CT patients had higher Charlson index compared to HD and PD patients (7.8±1.4, 6.1±2.2 and 4.5±2.3, respectively; p<0.001) Lack of autonomy and capacity for self-dialysis (n = 503; 63,8%), associated with the lack of a support network for assisted dialysis has been a very important limiting factor for self-care dialysis. Nevertheless, our PD program expanded since the implementation of our multidisciplinary pre-dialysis program (5.9 vs 15.2%). Conclusion Our multidisciplinary pre-dialysis education (PEP) program had a significant impact on ESRD treatment options, mainly with an increase of patients initiating dialysis with PD and CT.
Impact of a multidisciplinary pre-dialysis program on renal treatment modalities choice
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