SynthesisNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2021
Non-medical barriers reported by nephrologists when providing renal replacement therapy or comprehensive conservative management to end-stage kidney disease patients: a systematic review.
Synthesis in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Addressing the inequity of access to home Dialysis in Europe: recommendations for action informed by an international consensus exercise.BMC nephrology · 2025Article
- Combating the rising tide of kidney advocacy in Europe: the seminal role of the European Kidney Health Alliance (EKHA).Clinical kidney journal · 2025Review
- How does organisational culture facilitate uptake of home dialysis? An ethnographic study of kidney centres in England.BMJ open · 2024Article
- Barriers to conservative kidney management for Japanese healthcare professionals involved in the treatment of end-stage renal disease.Clinical and experimental nephrology · 2024Article
- Exploring Healthcare Paradoxes in Hospital Haemodialysis-A Qualitative Study.Health expectations : an international journal of public participation in health care and health policy · 2024Article
- Lower access to kidney transplantation for women in France is not explained by comorbidities and social deprivation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Shared decision-making in end-of-life care for end-stage renal disease patients: nephrologists' views and attitudes.Israel journal of health policy research · 2024Article
- Towards a better uptake of home dialysis in Europe: understanding the present and looking to the future.Clinical kidney journal · 2024Article
- Economic evaluation of dialysis and comprehensive conservative care for chronic kidney disease using the ICECAP-O and EQ-5D-5L; a comparison of evaluation instruments.Cost effectiveness and resource allocation : C/E · 2023Article
- Language barriers and kidney transplantation in children.Pediatric nephrology (Berlin, Germany) · 2023Article
- Factors influencing kidney transplantation rates: a study from the ERA Registry.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- Outpatient clinic specific for end-stage renal disease improves patient survival rate after initiating dialysis.Scientific reports · 2023Article
- Comorbidity is not associated with dialysis modality choice in patients with end-stage kidney disease.Nephrology (Carlton, Vic.) · 2022Article
- Results of the European EDITH nephrologist survey on factors influencing treatment modality choice for end-stage kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2021Article
- Choice of dialysis modality among patients initiating dialysis: results of the Peridialysis study.Clinical kidney journal · 2021Article
- Epirubicin Ameliorates Kidney Fibrosis by Inhibiting B56δ-Mediated Lipid Generation.Kidney diseases (Basel, Switzerland)Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLarge international differences exist in access to renal replacement therapy (RRT) modalities and comprehensive conservative management (CCM) for patients with end-stage kidney disease (ESKD), suggesting that some patients are not receiving the most appropriate treatment. Previous studies mainly focused on barriers reported by patients or medical barriers (e.g. comorbidities) reported by nephrologists. An overview of the non-medical barriers reported by nephrologists when providing the most appropriate form of RRT (other than conventional in-centre haemodialysis) or CCM is lacking.
methodsWe searched in EMBASE and PubMed for original articles with a cross-sectional design (surveys, interviews or focus groups) published between January 2010 and September 2018. We included studies in which nephrologists reported barriers when providing RRT or CCM to adult patients with ESKD. We used the barriers and facilitators survey by Peters et al. [Ruimte Voor Verandering? Knelpunten en Mogelijkheden Voor Verbeteringen in de Patiëntenzorg. Nijmegen: Afdeling Kwaliteit van zorg (WOK), 2003] as preliminary framework to create our own model and performed meta-ethnographic analysis of non-medical barriers in text, tables and figures.
resultsOf the 5973 articles screened, 16 articles were included using surveys (n = 10), interviews (n = 5) and focus groups (n = 1). We categorized the barriers into three levels: patient level (e.g. attitude, role perception, motivation, knowledge and socio-cultural background), level of the healthcare professional (e.g. fears and concerns, working style, communication skills) and level of the healthcare system (e.g. financial barriers, supportive staff and practice organization).
conclusionsOur systematic review has identified a number of modifiable, non-medical barriers that could be targeted by, for example, education and optimizing financing structure to improve access to RRT modalities and CCM.
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