What Is the Quality of Pre-Dialysis Healthcare in the Czech Republic?

Kidney and Blood Pressure Research

Sukeníková M.²  Rychlík I.³  Smržová J.⁴  Nehézová K.¹  Dvořák M.¹  Urbánek T.⁵ 

[1] Faculty of Medicine, MU Brno, Brno, $$;II. Internal Clinic, FNKV and 3rd Faculty of Medicine Charles University, Prague, Czech Republic$$;INMED, s.r.o., Svitavy, $$;Psychological Institute, Faculty of Arts, MU Brno, $$

关键词: Chronic kidney disease;    Early referral;    Pre-dialysis;    Dialysis preparation;    Patients education;   

DOI  :  10.1159/000336176

来源: S Karger AG

【 摘 要 】

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.

【 授权许可】

Unknown