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A prospective evaluation of renal replacement therapy modality eligibility
David C Mendelssohn1, Salim K Mujais, Steven D Soroka
1Humber River Regional Hospital, University of Toronto, Toronto, Ontario, Canada. dmendelssohn@hrrh.on.ca
Summary
Most chronic kidney disease (CKD) patients are eligible for renal replacement therapy (RRT). Haemodialysis (HD) and peritoneal dialysis (PD) have high eligibility rates, while transplant eligibility is lower, often due to age.
Area of Science:
- Nephrology
- Renal Replacement Therapy
- Chronic Kidney Disease
Background:
- Eligibility for renal replacement therapy (RRT) modalities is often debated.
- Limited prospective data exist for large patient cohorts regarding RRT eligibility.
Purpose of the Study:
- To prospectively evaluate medical and psychosocial eligibility for haemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation.
- To assess RRT modality eligibility across different stages of chronic kidney disease (CKD).
Main Methods:
- Prospective evaluation of medical and psychosocial eligibility for RRT modalities.
- Study included patients with CKD stages III-V enrolled in a North American prospective cohort.
- Data collected from seven North American nephrology practices.
Main Results:
- High medical eligibility for HD (98%) and PD (87%), lower for transplant (54%).
- Age was the primary barrier for PD and transplant eligibility; anatomical concerns and weight were also significant factors.
- Psychosocial eligibility was high for HD (95%), PD (83%), and transplant (71%).
Conclusions:
- Most CKD patients are deemed suitable for PD by healthcare providers.
- Enhanced patient education and promotion of home dialysis modalities are recommended to increase their use.
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