Patients' perspective of factors affecting modality selection: a National Kidney Foundation patient survey

The National Kidney Foundation undertook a survey of individuals with chronic renal failure to assess factors that may have influenced their treatment selection. Areas examined included demographic data, patient education, movement between modalities, patient satisfaction with treatment, and sense of well-being. The results point to a need for additional patient education and assurance that every ESRD patient is informed about all treatment options that are not medically contraindicated. There is an additional need for enhanced treatment decision making that involves both the patient and the nephrologist. Respondents were highly satisfied with their current treatment modality although 17% had previously changed treatment owing to personal dissatisfaction. Center hemodialysis patients identified staff performance of treatment and dialyzing only 3 times weekly as the main advantages of that modality. Those on peritoneal dialysis identified its flexibility that allows control over one's personal schedule as important. Transplant recipients stressed the importance of living a more normal life than that afforded by dialysis. Most respondents expressed a positive sense of well-being. While transplant patients expressed a higher sense of well-being than individuals on dialysis, it is important to note that approximately 70% of those on dialysis reported a positive sense of well-being.