What Is the Quality of Pre-Dialysis Healthcare in the Czech Republic?
| Authors | |
|---|---|
| Year of publication | 2012 |
| Type | Article in Periodical |
| Magazine / Source | KIDNEY & BLOOD PRESSURE RESEARCH |
| MU Faculty or unit | |
| Citation | |
| Doi | http://dx.doi.org/10.1159/000336176 |
| Field | Physiology |
| Keywords | Chronic kidney disease; Early referral; Pre-dialysis; Dialysis preparation; Patients education |
| Description | Aim: The PREPARE study (PRE-dialysis healthcare in PAtients initiating Renal rEplacement therapy and its consequences) evaluates the quality of pre-dialysis healthcare in patients commencing dialysis treatment in the Czech Republic. Methods: 48% of Czech dialysis centers participating in this prospective multicenter observational study provided data on all consecutive patients starting renal replacement therapy during 24 weeks. Results: 68% out of 303 patients had nephrological pre-dialysis care lasting >6 months (57% diabetics). Peritoneal dialysis (PD) was chosen by 11.2%. 23.6% of patients were receiving erythropoiesis-stimulating agents while the mean hemoglobin level was 98.3 +/- 15.6 g/l. 36.1% of patients were taking phosphate binders while serum phosphates reached 1.90 +/- 0.61 mmol/l. 64.4% of patients had a functional arteriovenous fistula or PD catheter. 91.8% of the patients felt they were well informed about hemodialysis and 51.6% about PD. Physicians reported poor compliance of patients in 15.1% of cases, while the patients evaluated their own compliance as 9.4%. Conclusions: To conclude: (1) better pre-dialysis care and information are needed; (2) higher awareness on PD might increase its low popularity; (3) particular attention should be paid to diabetics due to their higher morbidity, a lower proportion considered for transplantation and a lower proportion referred to nephrologists by diabetologists, and (4) preemptive transplantation should be considered more often. Copyright (C) 2012 S. Karger AG, Basel |