title: What is the quality of pre-dialysis healthcare in the Czech Republic?
abstract: OBJECTIVE
  The PREPARE study (PRE-dialysis healthcare in PAtients initiating Renal rEplacement therapy and its consequences) evaluates the quality of pre-dialysis healthcare in patients commencing dialysis treatment in the Czech Republic.
  
  
  METHODS
  48% of Czech dialysis centers participating in this prospective multicenter observational study provided data on all consecutive patients starting renal replacement therapy during 24 weeks.
  
  
  RESULTS
  68% out of 303 patients had nephrological pre-dialysis care lasting >6 months (57% diabetics). Peritoneal dialysis (PD) was chosen by 11.2%. 23.6% of patients were receiving erythropoiesis-stimulating agents while the mean hemoglobin level was 98.3 ±15.6 g/l. 36.1% of patients were taking phosphate binders while serum phosphates reached 1.90 ±0.61 mmol/l. 64.4% of patients had a functional arteriovenous fistula or PD catheter. 91.8% of the patients felt they were well informed about hemodialysis and 51.6% about PD. Physicians reported poor compliance of patients in 15.1% of cases, while the patients evaluated their own compliance as 9.4%.
  
  
  CONCLUSIONS
  To conclude: (1) better pre-dialysis care and information are needed; (2) higher awareness on PD might increase its low popularity; (3) particular attention should be paid to diabetics due to their higher morbidity, a lower proportion considered for transplantation and a lower proportion referred to nephrologists by diabetologists, and (4) preemptive transplantation should be considered more often.
authors.affiliation: INMED, s.r.o., Svitavy, Czech Republic. jsmrzova @ gmail.com
authors.forename: Jana
authors.initials: J
authors.lastname: Smržová
authors.forename: Tomáš
authors.initials: T
authors.lastname: Urbánek
authors.forename: Martin
authors.initials: M
authors.lastname: Dvořák
authors.forename: Michaela
authors.initials: M
authors.lastname: Sukeníková
authors.forename: Katarína
authors.initials: K
authors.lastname: Nehézová
authors.forename: Ivan
authors.initials: I
authors.lastname: Rychlík
mesh_terms: D000368:Aged; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*; D006435:Renal Dialysis / Q000592:standards* / Q000639:trends