title: Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views.
abstract: BACKGROUND
  Recent studies suggest discrepancies between patients and providers around perceptions of hemodialysis prognosis. Such data are lacking for continuous renal replacement therapy (CRRT). We aim to assess patient and provider understanding of outcomes around CRRT.
  
  
  METHODS
  From February 1 to August 31, 2013, a triad of (1) a patient on CRRT (or health care proxy [HCP]), (2) physician and (3) primary nurse from the intensive care unit (ICU) team were surveyed. Univariate chi-square and qualitative analysis techniques were used.
  
  
  RESULTS
  Ninety-six total participants (32 survey triads) were completed. Ninety one percent of patients/HCPs correctly identified that CRRT replaced the function of the kidneys. Six percent of patients/HCPs, 44 % of physicians, and 44 % of nurses identified rates of survival to hospital discharge that were consistent with published literature. Both physicians and nurses were more likely than patients/HCPs to assess survival consistently with published data (p = 0.001). Patients/HCPs were more likely to overestimate survival rates than physicians and nurses (p < 0.001). Thirty eight percent of patients/HCPs, 38 % of physicians, and 28 % of nurses identified rates of lifelong dialysis-dependence among surviving patients that were consistent with published literature.
  
  
  CONCLUSIONS
  There is mismatch between patients, HCPs, and providers around prognosis of CRRT. Patients/HCPs are more likely to overestimate chances of survival than physicians or nurses. Further intervention is needed to improve this knowledge gap.
authors.affiliation: Divsion of Nephrology, Department of Medicine, Massachusetts General Hospital, 7 Whittier Place, Suite 106, Boston, 02114, MA, USA. aallegretti@partners.org.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Allegretti
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. ghundemer@partners.org.
authors.forename: Gregory
authors.initials: G
authors.lastname: Hundemer
authors.affiliation: Divsion of Nephrology, Department of Medicine, Massachusetts General Hospital, 7 Whittier Place, Suite 106, Boston, 02114, MA, USA. rajchorghade@gmail.com.
authors.forename: Rajeev
authors.initials: R
authors.lastname: Chorghade
authors.affiliation: Divsion of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. kcosgrove@partners.org.
authors.forename: Katherine
authors.initials: K
authors.lastname: Cosgrove
authors.affiliation: Divsion of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. ebajwa@partners.org.
authors.forename: Ednan
authors.initials: E
authors.lastname: Bajwa
authors.affiliation: Divsion of Nephrology, Department of Medicine, Massachusetts General Hospital, 7 Whittier Place, Suite 106, Boston, 02114, MA, USA. ibhan@partners.org.
authors.forename: Ishir
authors.initials: I
authors.lastname: Bhan
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007362:Intensive Care Units; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010820:Physicians; D011379:Prognosis; D019727:Proxy; D006435:Renal Dialysis / Q000379:methods*; D017582:Renal Replacement Therapy / Q000379:methods