Observational studyBMC nephrology2017
Offering Patients Therapy Options in Unplanned Start (OPTiONS): Implementation of an educational program is feasible and effective.
Observational study in BMC nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Urgent-start peritoneal dialysis versus haemodialysis for people with chronic kidney disease.The Cochrane database of systematic reviews · 2021Pooled it
- Urgent-start peritoneal dialysis versus conventional-start peritoneal dialysis for people with chronic kidney disease.The Cochrane database of systematic reviews · 2020Pooled it
- Decision Readiness and Determinants of KRT among Veterans with Advanced CKD.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Educating acute dialysis patients - can we do better?Future healthcare journal · 2024Article
- Article
- Choice of dialysis modality among patients initiating dialysis: results of the Peridialysis study.Clinical kidney journal · 2021Article
- A Digital Modality Decision Program for Patients With Advanced Chronic Kidney Disease.JMIR formative research · 2019Article
- Optimal start in dialysis shows increased survival in patients with chronic kidney disease.PloS one · 2019Article
- Risk Factors for Unplanned Dialysis Initiation: A Systematic Review of the Literature.Canadian journal of kidney health and disease · 2019Article
- Prescribing Hemodialysis or Hemodiafiltration: When One Size Does Not Fit All the Proposal of a Personalized Approach Based on Comorbidity and Nutritional Status.Journal of clinical medicine · 2018Article
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Authors and funding
8 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients.
methodsThis non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter. Effects of UPS-EP on choice and final decision of dialysis therapy and outcomes within 12 months of follow up were analysed.
resultsAmong 270 UPS patients who had an unplanned start to dialysis, 214 were able to receive and 203 complete UPS-EP while 56 patients - who were older (p = 0.01) and had higher Charlson comorbidity index (CCI; p < 0.01) - did not receive UPS-EP. Among 177 patients who chose dialysis modality after UPS-EP, 103 (58%) chose PD (but only 86% of them received PD) and 74 (42%) chose HD (95% received HD). Logistic regression analysis showed that diabetes 1.88 (1.05 - 3.37) and receiving UPS-EP, OR = 4.74 (CI, 2.05 - 10.98) predicted receipt of PD. Patients choosing PD had higher CCI (p = 0.01), higher prevalence of congestive heart failure (p < 0.01) and myocardial infarction (p = 0.02), and were more likely in-patients (p = 0.02) or referred from primary care (p = 0.02). One year survival did not differ significantly between PD and HD patients. Peritonitis and bacteraemia rates were better than international guideline standards.
conclusionsUPS-EP predicted patient use of PD but 14% of those choosing PD after UPS-EP still did not receive the modality they preferred. Patient survival in patients choosing and/or receiving PD was similar to HD despite age and comorbidity disadvantages of the PD groups.
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