ArticleBMC nephrology2026
How pre-education affects patients choosing appropriate renal replacement treatment: a retrospective study.
Article in BMC nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionWorldwide, only 11% of dialysis patients are treated by peritoneal dialysis (PD), however many of those treated by haemodialysis (HD) do not receive any pre-dialysis education thereby excluding informed choice. Just over 4% of such patients are treated by PD in Poland. This study retrospectively evaluates the impact of pre-education on patient decisions made for renal replacement therapy to determine those factors that limit making PD as the treatment of choice in Poland. METHODOLOGY: Subjects were 118 patients having received pre-dialysis education for over 3 years consisting of a fixed scheduled meeting lasting 1.5-2.0 h, according to patient needs, during routine work at a PD clinic in Warsaw. Subjects were broken down into groupings according to demographics, clinical features, lifestyle/domestic conditions and criteria used for PD/HD inclusions to determine significant factors affecting treatment choice by using parametric or non-parametric significance testing as appropriate. Significant associations were determined by univariate logistic regression.
resultsNo medical or psychosocial obstacles to PD treatment were found in 75 patients (63.5%), whereas relative contraindications were found 17 patients (14.4%), assisted dialysis was necessary in 19 patients (16.1%) and 7 patients (6.0%) were disqualified. PD was chosen by 74 patients (62.7%) and 44 patients (37.3%) decided on HD, where in the former group, PD treatment was actually undertaken in 61 (52%) of study subjects. Occupationally active people and retirees/pensioners chose PD more often and most patients (91.5%) declared having suitable home conditions for PD treatment. Factors significantly reducing prospects for PD were advanced age (p = 0.010), diabetes (p = 0.008), high BMI (p = 0.010), presence of scars from abdominal surgeries (p = 0.029) and reliance on third parties (p = 0.013).
conclusionsMost subjects qualifying for renal replacement therapy had no contraindications for PD. Thanks to pre-dialysis education, > 50% could choose this treatment option. The main barriers found to having home-based renal replacement therapy were a lack of appropriate education and limited access to assisted PD.
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