Portal de Periódicos da CAPES

Analysis of Patient Flow into Dialysis: Role of Education in Choice of Dialysis Modality

2005; SAGE Publishing; Volume: 25; Issue: 3_suppl Linguagem: Inglês

10.1177/089686080502503s14

1718-4304

Belén Marrón, Juan Ocaña, Mercedes Salgueira, Guillermina Barril, José M. Lamas, Marisa Martín, Tomás Sierra, Ana Rodríguez–Carmona, Amparo Soldevilla, Francisco Martínez, I Castellano, S. Pedro de Alcántara, Joaquín Sotelo González, Juan Ramón Jiménez, R Moll, Ana Balius, Francisco Coronel, José Antonio Herrero, E Gago, Rosa Arias, Pilar Galindo, G. Rguez Goyanes, Rosa Ranero, Isabel Gimeno, Javier Mardaras, Olimpia Ortega, M Munar, Carlos Solozábal, J. C. Alonso, Patricia de Sequera, Nicanor Vega, Paloma Sanz, Alfonso de Palma, Virgen Macarena,

Central Venous Catheters and Hemodialysis

Despite advances in predialysis care, morbidity and mortality remain high.To analyze end-stage renal disease (ESRD) patient demographics and clinical data on education on dialysis treatment options, type of chronic renal replacement therapy (RRT), and effects of planned versus non-planned dialysis start.621 patients, from 24 Spanish hospitals, who started RRT in 2002. Peritoneal or vascular access at dialysis initiation was considered "planned."304 (49%) patients were non-planned and half of them had prior nephrology follow-up. Of the patients with >3 months nephrology follow-up (76% of all), only half were educated on dialysis modalities. Dialysis education was associated with planned start in 73.4% versus 26% in non-educated patients (p < 0.05), shorter follow-up (55 vs 65 months, p = 0.033), more medical visits in the prior year (6.5 vs 4.4, *p < 0.001), more patients starting peritoneal dialysis (31% vs 8.3%*), and more specific follow-up by ESRD unit versus general nephrology care (63% vs 26%*). Non-planned start was associated with older age (63 vs 60.6 years, p = 0.06), fewer medical visits (4.6 vs 6.4*), less education about modality options, and greater use of hemodialysis (92% vs 75%*). Planned patients had better biochemical parameters at start of dialysis.Despite nephrology follow-up, half the patients did not have a planned dialysis start. Planned start was associated with better clinical status. More patients chose peritoneal dialysis when educated about dialysis modality options. ESRD-specific units were more likely to provide patient education.