Goovaerts T et al. (2005) Influence of a pre-dialysis education programme (PDEP) on the mode of renal replacement therapy. Nephrol Dial Transplant 20: 1842–1847

End-stage renal disease can be treated using a range of renal replacement therapy (RRT) modalities. Uptake of the various modalities varies between countries and centers. This retrospective Belgian study reports that, in one center where patients were provided with predialysis education, most chose a self-care modality.

Of 242 patients beginning RRT during the 6-year study period, 57 were directed towards in-center hemodialysis, the majority for medical or psychosocial reasons. The rest were provided with information about RRT options, including continuous ambulatory peritoneal dialysis, automated peritoneal dialysis, in-center hemodialysis, self-care hemodialysis in a satellite unit and home hemodialysis. Education included individual discussion with a dialysis nurse in charge of the self-care modalities and viewing videos about the range of treatment options.

Eight patients underwent pre-emptive renal transplant. Of the remainder, 60% chose self-care dialysis modalities. Patients choosing self care were, on average, younger than those choosing in-center modalities. Treatment choice also correlated with the cause of end-stage renal disease: patients with chronic glomerulonephritis or chronic interstitial nephritis were more likely to opt for self care.

As no comparison was performed with patients who received no predialysis education, it is not possible to conclude that the education program affected patients' treatment choices. In this center, however, patients made choices that allowed in-house resources to be focused on those with more complex medical needs.