Journal Article

Attitudes of British Isles nephrologists towards dialysis modality selection: a questionnaire study

Sarbjit Vanita Jassal, Ganesh Krishna, Netar P. Mallick and David C. Mendelssohn

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 17, issue 3, pages 474-477
Published in print March 2002 | ISSN: 0931-0509
Published online March 2002 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/17.3.474
Attitudes of British Isles nephrologists towards dialysis modality selection: a questionnaire study

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Background. Dialysis demographics are changing around the world. Within the UK a striking decrease in the overall use of peritoneal dialysis (PD) has been noted. We set out to determine the opinions and attitudes of British Isles nephrologists about dialysis modality decisions and optimal dialysis system design.

Methods. A survey questionnaire was mailed to a random selection of members of the Renal Association of Great Britain and Ireland.

Results. A 63% response rate was achieved. Decisions about dialysis modality were based mostly on patient preference (mean score 4.4 on a scale of 1–5), quality of life data (mean score 3.8), and morbidity and mortality data (mean scores for both 3.6). The least important factors when choosing the modality of dialysis care were the treatment costs to either the patient or the health care system. Respondents felt that both PD and hospital‐based haemodialysis (HD) were over‐utilized in today's practice. They suggested that an ‘ideal dialysis system’ (based on patient survival, wellness, and quality of life) should have 27% of patients dialysed using hospital‐based HD, 24% in a satellite unit, 11% dialysed using home HD, and 38% on some form of PD (19, 16, and 3% for CAPD, automated PD and intermittent PD, respectively). Few differences were identified between an ideal system which optimized patient survival, wellness, and quality of life, compared with one which optimized cost‐effectiveness.

Conclusion. This survey suggests that most nephrologists in the British Isles feel that hospital‐based HD and CAPD are being currently overused, and that future dialysis planning should include a higher proportion of patients on satellite dialysis, home HD, and automated PD to optimize both dialysis cost‐effectiveness and patient outcomes.

Keywords: haemodialysis; modality; selection peritoneal dialysis

Journal Article.  2568 words. 

Subjects: Nephrology

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