title: Patients' preferences regarding choice of end-stage renal disease treatment options.
abstract: BACKGROUND
  Dialysis registries have reported a low take-up of home treatment. The aim of our study was to report patients' preferred treatment options for end-stage renal disease (ESRD) after information delivery, patients' characteristics by treatment preference, and the reasons for differences between treatment preference and the treatment delivered.
  
  
  METHODS
  A prospective cohort study on patients seen in our nephrology department between January 2009 and June 2011 included all patients with chronic kidney disease (GFR <20 ml/min/1.73 m(2)) and incident dialysis patients who received an information program about ESRD treatment options.
  
  
  RESULTS
  228 patients received information delivery and either expressed a preference for a given renal replacement therapy (peritoneal dialysis, PD: 42%; hemodialysis, HD: 33%), remained undecided (20%) or expressed reluctance to undergo renal replacement therapy (5%). Multivariate analysis revealed that compared to HD preference, patients preferring PD were older (OR 1.02, 95% CI 1.0-1.04), had a lower BMI (OR 0.9, 95% CI 0.87-0.98) and were more likely to have been informed before rather than after starting dialysis (OR 3.4, 95% CI 1.5-7.4); home treatment was the main reason given for preferring PD. Undecided patients were mainly women and the majority were eventually treated by HD. Reluctant patients were the oldest (OR 1.12, 95% CI 1.02-1.22) and were rarely treated by dialysis. Only 24% of patients informed before and 8% of patients informed after starting dialysis were ultimately treated with PD. Reasons for a mismatch between dialysis modality preference and treatment delivered were equally distributed between medical and nonmedical.
  
  
  CONCLUSIONS
  Patients should be systematically informed before starting dialysis, patients' preferences should be taken into account before organizing dialysis and all treatment modalities should be available in all centers.
authors.affiliation: Service de Néphrologie-Dialyse-Transplantation, Hôpital Pasteur, CHU de Nice, Nice, France.
authors.forename: Abdelmouttalib
authors.initials: A
authors.lastname: Maaroufi
authors.forename: Coraline
authors.initials: C
authors.lastname: Fafin
authors.forename: Sophie
authors.initials: S
authors.lastname: Mougel
authors.forename: Guillaume
authors.initials: G
authors.lastname: Favre
authors.forename: Barbara
authors.initials: B
authors.lastname: Seitz-Polski
authors.forename: Ahmed
authors.initials: A
authors.lastname: Jeribi
authors.forename: Sandor
authors.initials: S
authors.lastname: Vido
authors.forename: Catherine
authors.initials: C
authors.lastname: Dewisme
authors.forename: Laetitia
authors.initials: L
authors.lastname: Albano
authors.forename: Vincent
authors.initials: V
authors.lastname: Esnault
authors.forename: Olivier
authors.initials: O
authors.lastname: Moranne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006436:Hemodialysis Units, Hospital; D006437:Hemodialysis, Home; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D057240:Patient Preference; D010530:Peritoneal Dialysis