Mario Prieto?Velasco|Pedro Quiros|C Remón
The Concordance between Patients’ Renal Replacement Therapy Choice and Definitive Modality: Is It a Utopia?
Complejo Asistencial Universitario de Palencia|Hospital Universitario Puerto Real|Hospital Universitario Puerto Real
introduction desirable patients play active roles choice renal replacement therapy rrt patient decision aid tools pdas developed allow patients choose option best suited individual needs material methods observational prospective registry conducted 26 spanish hospitals september 2010 may 2012 results patients choice definitive rrt modality registered progressive implementation education process ep pdas designed help chronic kidney disease ckd patients choose rrt results patients included study 1044 569 patients used pdas made definitive choice end registration total 884 patients chose dialysis 43 hemodialysis hd 45 peritoneal dialysis pd 32 preemptive livingdonor transplant tx 84 conservative treatment ct total 399 patients began rrt period distribution 934 dialysis 536 hd 40 pd 13 preemptive tx 53 ct patients followed ep changed mind significantly less often kappa value 091 95 ci 086095 follow despite starting unplanned treatment kappa value 085 95 ci 075095 higher agreement final choice definitive treatment achieved ep planned patients kappa value 093 95 ci 089098 go ep much lower index choosing pd changed decision frequently starting definitive treatment kappa value 073 95 ci 055091 conclusions free choice assisted pdas leads 5050 distribution pd hd choice increase tx choice use pdas even unplanned start achieved high level concordance chosen definitive modality