title: Effects of a pre-dialysis patient education program on the relative frequencies of dialysis modalities.
abstract: BACKGROUND
  Pre-dialysis education can guide the choice of the dialysis modality best tailored to meet the needs and preferences of individual patients with chronic kidney disease.
  
  
  METHODS
  In a retrospective single-center cohort study, we evaluated the impact of a pre-dialysis education program on the incidence rates of patients using hemodialysis (HD) and peritoneal dialysis (PD) in our unit. The frequency distribution of dialysis modalities between people attending our education program and people not attending the program (control group) was analyzed for the 4-year period 2004 - 2008.
  
  
  RESULTS
  From among all the incident chronic kidney disease 5D patients presenting during the 4-year period, we analyzed 227 who started dialysis either with an arteriovenous fistula or a PD catheter. In that cohort, 70 patients (30.8%) took part in the education program, and 157 (69.2%) did not receive structured pre-dialysis counseling. In the group receiving education, 38 patients (54.3%) started with PD, and 32 (45.7%), with HD. In the standard-care group not receiving education, 44 patients (28%) started with PD, and 113 (72%), with HD (p < 0.001).
  
  
  CONCLUSIONS
  Our multidisciplinary pre-dialysis program had a significant impact on the frequency distribution of dialysis modalities, increasing the proportion of patients initiating dialysis with PD.
authors.affiliation: Department of Internal Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Ribitsch
authors.forename: Bernd
authors.initials: B
authors.lastname: Haditsch
authors.forename: Ronald
authors.initials: R
authors.lastname: Otto
authors.forename: Gernot
authors.initials: G
authors.lastname: Schilcher
authors.forename: Franz
authors.initials: F
authors.lastname: Quehenberger
authors.forename: Johannes M
authors.initials: JM
authors.lastname: Roob
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Rosenkranz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010530:Peritoneal Dialysis / Q000706:statistics & numerical data*; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000628:therapy; D012189:Retrospective Studies
keywords: Dialysis modalities; integrated care concept; pre-dialysis education
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