Dialysis Program on Renal Treatment Modalities Choice from the Journal of Clinical Nephrolog

Introduction

In Portugal, approximately 2,500 patients with end-stage chronic kidney disease (CKD stage 5) begin renal replacement therapy (RRT) each year. The choice between kidney transplantation (TX), hemodialysis (HD), peritoneal dialysis (PD), or conservative treatment (CT) is complex, impacting quality of life and long-term health outcomes.

A recent study published in the Journal of Clinical Nephrology highlights the effectiveness of a multidisciplinary pre-dialysis education program in helping patients make informed treatment decisions. This initiative emphasizes patient-centered care, providing guidance through consultations, educational materials, and direct patient interactions.

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Key Findings from the Study

Informed Decision-Making: Patients who participated in the pre-dialysis education program had a clearer understanding of treatment options. Those with early awareness were more likely to choose self-care dialysis options like PD.

Dialysis Choice Distribution:

• 59% opted for Hemodialysis (HD) – The most common choice, often due to accessibility and hospital support.
• 19% chose Peritoneal Dialysis (PD) – Younger patients with fewer comorbidities showed a preference for home-based dialysis.
• 12% selected Conservative Treatment (CT) – This was more common among older patients with multiple health conditions.

Barriers to Peritoneal Dialysis: The study identified key challenges limiting PD adoption, including:
Elderly patients’ reduced manual dexterity and visual acuity
Lack of support networks for assisted PD
Fear and anxiety related to self-dialysis

The Role of Social and Clinical Factors:

• Younger patients and those with fewer comorbidities were more likely to choose PD.
• Patients who lived far from hemodialysis centers or had high morbidity tended to opt for CT.

Read the full study at: DOI: 10.29328/journal.jcn.1001073

The Importance of Pre-Dialysis Education

Providing structured, multidisciplinary education before dialysis initiation has proven benefits:
Reduces stress and anxiety associated with treatment choices
Promotes self-care therapies, enhancing quality of life
Minimizes unnecessary invasive procedures
Encourages patients to take an active role in their treatment

A similar approach has been successful in other countries, demonstrating that early intervention leads to better patient outcomes.

Looking Ahead Expanding the Progra

To increase patient access to self-care dialysis, healthcare policymakers could:
Implement home nurse support for peritoneal dialysis
Enhance education on the benefits of self-care dialysis
Address logistical challenges for elderly and socially isolated patients

The study underscores the need for integrated healthcare policies that prioritize patient autonomy and long-term well-being.

Join the Conversation!

What are your thoughts on patient education in dialysis treatment? Share your experiences in the comments below!

For more insights into nephrology research, visit HSPIOA.

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